Organization Active NPI

Western Kentucky Gastroenterology, LLC

  • Gastroenterology Physician
  • Bowling Green, KY
National Provider Identifier
1295777084
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
WESTERN KENTUCKY GASTROENTEROLOGY, LLC
Practice address
996 Wilkinson Trce
Suite a-10
Bowling Green, KY 42103-3407
Phone
(270) 393-9829
Fax
(270) 393-9830
NPI assigned
Jun 13, 2006
Organization subpart
Yes
Parent organization
HOSPITAL CORP., LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chuck Locke
Title
VP
Phone
(615) 373-7604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

996 Wilkinson Trce
Suite a-10
Bowling Green, KY 42103-3407

Mailing address

996 Wilkinson Trce
Suite a-10
Bowling Green, KY 42103-3407
Phone (270) 393-9829

Other identifiers 1

IdentifierTypeStateIssuer
65944050MedicaidKY

National Provider Directory

National Provider Directory

Locations

996 Wilkinson Trce
Ste A10
Bowling Green, KY 42103
Phone (270) 393-9829

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1295777084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 WILKINSON TRCE",
            "address_2": "SUITE A-10",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033407",
            "telephone_number": "270-393-9829",
            "fax_number": "270-393-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 WILKINSON TRCE",
            "address_2": "SUITE A-10",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033407",
            "telephone_number": "270-393-9829",
            "fax_number": "270-393-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN KENTUCKY GASTROENTEROLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL CORP., LLC",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7604"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.