NPIMap

Organization Active NPI

Southern Ky Nephrology

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1346379864
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SOUTHERN KY NEPHROLOGY
Practice address
720 E 2ND Ave
Suite 301
Bowling Green, KY 42101-1778
Phone
(270) 843-5114
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott C Sims, MDNPI 1568425106
Title
President
Phone
(270) 843-5114

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
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

720 E 2ND Ave
Suite 301
Bowling Green, KY 42101-1778

Mailing address

720 E 2ND Ave
Suite 301
Bowling Green, KY 42101-1778
Phone (270) 843-5114

Other identifiers 1

IdentifierTypeStateIssuer
7890181600MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Southern Kentucky Neph As2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

720 2nd Ave
Ste 301
Bowling Green, KY 42101
Phone (270) 843-5114

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346379864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E 2ND AVE",
            "address_2": "SUITE 301",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011778",
            "telephone_number": "270-843-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E 2ND AVE",
            "address_2": "SUITE 301",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011778",
            "telephone_number": "270-843-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KY NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-843-5114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7890181600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • 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.