NPIMap

Individual provider Active NPI

Jerry Wayne Lawson, MD

  • Family Medicine Physician
  • Jamestown, KY
National Provider Identifier
1326046913
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33028 Issued in KY
Practice address
1417 N Main Street
Jamestown, KY 42629-0966
Phone
(270) 343-2597
Fax
(270) 343-2598
NPI assigned
Jul 8, 2005
Last updated
Jun 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33028 KY Primary

Addresses

Primary practice location

1417 N Main Street
Jamestown, KY 42629-0966

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 864-1472

Other identifiers 1

IdentifierTypeStateIssuer
64330285MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000690 KY Practitioner - Family Practice 1052363017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russell County HospitalGroup PAC ID 6204887243, 22 clinicians

Practice addresses (Care Compare)

1417 N Main St
Jamestown, KY 42629-2411
Phone (270) 343-2597

153 Dowell Rd
Russell Springs, KY 42642-4579
Phone (270) 866-4141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33028KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Russell County Hospital CurrentSince Jul 28, 2013 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Apr 25, 2016 Accepting new patients
Russell County Hospital Current Accepting new patients
Russell County Hospital Family Medicine CurrentSince Jul 28, 2013 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Apr 25, 2016 Accepting new patients
Jamestown Healthcare Clinic LLC Family Medicine Current Accepting new patients
Russell County Hospital Past Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients
Jamestown Healthcare Clinic, LLC PastSince Jan 1, 2006 Accepting new patients
Fair Oaks Health and Rehabilitation LLC Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

1417 N Main St
Jamestown, KY 42629
Phone (270) 343-2597

124 Dowell Rd
Russell Springs, KY 42642
Phone (270) 866-2440

153 Dowell Rd
Russell Springs, KY 42642
Phone (270) 866-4141

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDFGBD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1326046913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-864-1472",
            "fax_number": "270-864-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N MAIN STREET",
            "city": "JAMESTOWN",
            "state": "KY",
            "postal_code": "426290966",
            "telephone_number": "270-343-2597",
            "fax_number": "270-343-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "33028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64330285",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, KY

Sources for this page

Verify at the official NPI Registry.