NPIMap

Organization Active NPI

Our Lady Bellefonte Hospital, Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Ashland, KY
National Provider Identifier
1306907480
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
40015 Issued in KY
Legal business name
OUR LADY BELLEFONTE HOSPITAL, INC
Practice address
1150 Saint Christopher Dr
Ashland, KY 41101-7055
Phone
(606) 833-0144
Fax
(606) 833-0113
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Chris Wilde
Title
Cfo
Phone
(606) 833-0144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 40015 KY Primary

Addresses

Primary practice location

1150 Saint Christopher Dr
Ashland, KY 41101-7055

Mailing address

1150 Saint Christopher Dr
Ashland, KY 41101-7055
Phone (606) 833-0144

Other names 1

  • Bellefonte Pain Management and Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of Bellefonte5 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1150 Saint Christopher Dr
Ashland, KY 41101
Phone (606) 833-0311

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306907480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017055",
            "telephone_number": "606-833-0144",
            "fax_number": "606-833-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017055",
            "telephone_number": "606-833-0144",
            "fax_number": "606-833-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY BELLEFONTE HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "606-833-0144"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "KY",
            "license": "40015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellefonte Pain Management and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.