Jacquelynn Anne Liddington, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA147 Issued in KY

Practice address

1239 Woodland Dr Ste 105
Elizabethtown, KY 42701-2770

Phone

(270) 765-7676

Fax

(270) 982-9222

NPI assigned

Dec 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326106873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 CHERRY SPRING RD",
            "city": "CUB RUN",
            "state": "KY",
            "postal_code": "427298629",
            "telephone_number": "270-524-4257",
            "fax_number": "270-982-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 WOODLAND DR STE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012770",
            "telephone_number": "270-765-7676",
            "fax_number": "270-982-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDINGTON",
        "first_name": "JACQUELYNN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nick Lepora, DO
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• Judith L. Lesher, CCC-SLP
• Holly Jo Lewis, PT, DPT, OCS
• Ronald Lewis, CRNA
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• Thaddeus John Ligon
• Angela Gail Lile, PT

• Medical Physician Assistant in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.