NPIMap

Organization Active NPI

Chipps, Caffrey & Dubilier, P.S.C

  • Anatomic Pathology & Clinical Pathology Physician
  • Lexington, KY
National Provider Identifier
1336148683
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
CHIPPS, CAFFREY & DUBILIER, P.S.C
Practice address
290 Big Run Rd
Lexington, KY 40503-2903
Phone
(859) 278-9513
Fax
(859) 277-6063
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Dr. Jason A Clark, M.D.NPI 1508033747
Title
President
Phone
(859) 278-9513

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
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

290 Big Run Rd
Lexington, KY 40503-2903

Mailing address

290 Big Run Rd
Lexington, KY 40503-2903
Phone (859) 278-9513

Other identifiers 1

IdentifierTypeStateIssuer
65907834MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jporter@pandclab.com Direct
Direct Messaging Address jporter@pandclab.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040106000573 KY Part B Supplier - Clinic/Group Practice 4688573900 Receives reassigned benefits from 21 practitioners
Practice locations: Frankfort, KY; Prestonsburg, KY; Lexington, KY; Harlan, KY

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1336148683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BIG RUN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032903",
            "telephone_number": "859-278-9513",
            "fax_number": "859-277-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BIG RUN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032903",
            "telephone_number": "859-278-9513",
            "fax_number": "859-277-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPS, CAFFREY & DUBILIER, P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-278-9513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65907834",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jporter@pandclab.com",
            "affiliation": "N",
            "endpointDescription": "Mailing address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "290 Big Run Rd",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405032903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jporter@pandclab.com",
            "affiliation": "N",
            "endpointDescription": "Mailing address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "290 Big Run Rd",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405032903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.