Prospect Pediatrics, PSC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PROSPECT PEDIATRICS, PSC

Practice address

9217 US Highway 42
Prospect, KY 40059-8858

Phone

(502) 228-1312

Fax

(502) 753-2998

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terence P McKenna, M.D.

Title

President

Phone

(502) 228-1312

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336298652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598858",
            "telephone_number": "502-228-1312",
            "fax_number": "502-753-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598858",
            "telephone_number": "502-228-1312",
            "fax_number": "502-753-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT PEDIATRICS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-228-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65914376000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Sue Redman, MSN, APRN, FNP-C

• Pediatrics Physician in Prospect, KY
• Providers in Prospect, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.