Organization Active NPI

Elliott Psychiatric Services, PLLC

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1336188788
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ELLIOTT PSYCHIATRIC SERVICES, PLLC
Practice address
851 Corporate Dr
Suite 203
Lexington, KY 40503-5428
Phone
(859) 219-0090
Fax
(859) 219-0339
NPI assigned
Jun 4, 2006
Last updated
Oct 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Robert E Elliott, M.D.NPI 1881691657
Title
President
Phone
(859) 219-0090

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

851 Corporate Dr
Suite 203
Lexington, KY 40503-5428

Mailing address

851 Corporate Dr
Suite 203
Lexington, KY 40503-5428
Phone (859) 219-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050621000262 KY Part B Supplier - Clinic/Group Practice 6103861281 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

851 Corporate Dr
Ste 203
Lexington, KY 40503
Phone (859) 219-0090

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1336188788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 CORPORATE DR",
            "address_2": "SUITE 203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035428",
            "telephone_number": "859-219-0090",
            "fax_number": "859-219-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 CORPORATE DR",
            "address_2": "SUITE 203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035428",
            "telephone_number": "859-219-0090",
            "fax_number": "859-219-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT PSYCHIATRIC SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-219-0090",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 18, 2012; 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.