Sleep Source Kentucky, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

3618 Issued in KY

Legal business name

SLEEP SOURCE KENTUCKY, LLC

Practice address

100 N 6TH St
Murray, KY 42071-2000

Phone

(270) 768-0080

Fax

(270) 768-0081

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Sexton

Title

Co-Owner

Phone

(270) 575-0080

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1295883718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 PARISA DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034584",
            "telephone_number": "270-575-0080",
            "fax_number": "270-575-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N 6TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712000",
            "telephone_number": "270-768-0080",
            "fax_number": "270-768-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP SOURCE KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "270-575-0080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "3618",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "3618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B #",
            "identifier": "9379301",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000324218",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghanshyam S Shastri, M.D.
• Christian Nicole Shaw, RDN, LD
• Tara Shawn Shelton, RD,LD,CDE
• Erica L Shepard
• Raymond Edward Sheridan, LPCA
• Michelle Smart, ARNP
• Megan Murphy Smetana, MS, CCC-SLP
• Smiling Faces LLC
• Graham Smith, MD
• Jennette N Smith

• Durable Medical Equipment & Medical Supplies in Murray, KY
• Providers in Murray, KY by specialty
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.