Kentuckiana Thoracic & Vascular Surgery. P.C/

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

27240 Issued in KY

Legal business name

KENTUCKIANA THORACIC & VASCULAR SURGERY. P.C/

Practice address

1919 State St
Suite 364
New Albany, IN 47150-4929

Phone

(812) 949-8355

Fax

(812) 949-4941

NPI assigned

Mar 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Franco Ralph Rea, M.D.

Title

Physician/Owner

Phone

(812) 949-8355

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1346411188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 STATE ST",
            "address_2": "SUITE 364",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504929",
            "telephone_number": "812-949-8355",
            "fax_number": "812-949-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE ST",
            "address_2": "SUITE 364",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504929",
            "telephone_number": "812-949-8355",
            "fax_number": "812-949-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA THORACIC & VASCULAR SURGERY. P.C/",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "REA",
        "authorized_official_first_name": "FRANCO",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "812-949-8355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "27240",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "04712",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200897280 A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64272404",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  IN&KY",
            "identifier": "000000562595",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.