NPIMap

Organization Active NPI

American Surgical Specialists, PLLC

Doing business as Bluegrass Surgical Specialists

  • Surgery Physician
  • Prestonsburg, KY
National Provider Identifier
1316254261
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
41691 Issued in KY
Legal business name
AMERICAN SURGICAL SPECIALISTS, PLLC
Doing business as
Bluegrass Surgical Specialists
Practice address
400 University Dr
Suite 105
Prestonsburg, KY 41653-1080
Phone
(606) 886-1077
Fax
(606) 886-1170
NPI assigned
Sep 13, 2010
Last updated
Apr 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Phillip Parker Crace, MDNPI 1003088972
Title
Owner
Phone
(606) 886-1077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 41691 KY Primary

Addresses

Primary practice location

400 University Dr
Suite 105
Prestonsburg, KY 41653-1080

Mailing address

400 University Dr
Suite 105
Prestonsburg, KY 41653-1080
Phone (606) 886-1077

Other identifiers 2

IdentifierTypeStateIssuer
7100011360MedicaidKY
7100152550MedicaidKY

Other names 1

  • Bluegrass Surgical Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

400 University Dr
Ste 212
Prestonsburg, KY 41653
Phone (606) 785-5074

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": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1316254261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 UNIVERSITY DR",
            "address_2": "SUITE 105",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531080",
            "telephone_number": "606-886-1077",
            "fax_number": "606-886-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 UNIVERSITY DR",
            "address_2": "SUITE 105",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531080",
            "telephone_number": "606-886-1077",
            "fax_number": "606-886-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN SURGICAL SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "CRACE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "PARKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-886-1077",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": "41691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100011360",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100152550",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluegrass Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prestonsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.