NPIMap

Organization Active NPI

Kentucky Mso LLC

Doing business as Central Kentucky Oncology and Hematology

  • Hematology & Oncology Physician
  • Georgetown, KY
National Provider Identifier
1336483957
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
KENTUCKY MSO LLC
Doing business as
Central Kentucky Oncology and Hematology
Practice address
1140 Lexington Rd
Suite 202
Georgetown, KY 40324-9330
Phone
(502) 868-5603
Fax
(502) 868-5612
NPI assigned
Nov 20, 2012
Last updated
Sep 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Authorized official

Name
Kathy Teague
Title
Corporate Secretary
Phone
(615) 920-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

1140 Lexington Rd
Suite 202
Georgetown, KY 40324-9330

Mailing address

1140 Lexington Rd
Suite 202
Georgetown, KY 40324-9330
Phone (502) 868-5603

Other practice location 1

225 Hospital Dr Ste 325
Winchester, KY 40391-7665
Phone (502) 868-5603

Other names 1

  • Central Kentucky Oncology and Hematology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110901000380 KY Part B Supplier - Clinic/Group Practice 0749450633 Receives reassigned benefits from 104 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Versailles, KY; Paris, KY; Mount Sterling, KY; West Liberty, KY; Winchester, KY; Georgetown, KY; Lawrencburg, KY; Lawrenceburg, KY…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

105 Prather Path
Ste 1200
Georgetown, KY 40324
Phone (502) 570-3785

1138 Lexington Rd
Ste 203
Georgetown, KY 40324
Phone (502) 570-3778

1502 Oxford Dr
Ste 100
Georgetown, KY 40324
Phone (502) 570-3785

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1336483957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 LEXINGTON RD",
            "address_2": "SUITE 202",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249330",
            "telephone_number": "502-868-5603",
            "fax_number": "502-868-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 LEXINGTON RD",
            "address_2": "SUITE 202",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249330",
            "telephone_number": "502-868-5603",
            "fax_number": "502-868-5612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Hospital Dr Ste 325",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "KY",
            "postal_code": "403917665",
            "country_code": "US",
            "telephone_number": "502-868-5603",
            "fax_number": "502-868-5608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENTUCKY MSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Kentucky Oncology and Hematology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Kentucky Oncology and Hematology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

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