Lexington Diabetic Center PSC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

39043 Issued in KY

Legal business name

LEXINGTON DIABETIC CENTER PSC

Practice address

3292 Eagle View LN
Suite 210
Lexington, KY 40509-2173

Phone

(859) 977-8855

Fax

(859) 977-8856

NPI assigned

Jan 5, 2007

Last updated

Jan 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael C. Allen

Title

Ceo

Phone

(859) 977-8855

Specialties & licenses 2

Addresses

Other identifiers 7

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1356499602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3292 EAGLE VIEW LN",
            "address_2": "SUITE 210",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092173",
            "telephone_number": "859-977-8855",
            "fax_number": "859-977-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 EAGLE VIEW LN",
            "address_2": "SUITE 210",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092173",
            "telephone_number": "859-977-8855",
            "fax_number": "859-977-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON DIABETIC CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-977-8855"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "KY",
            "license": "39043",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TG LDC RAILROAD PIN",
            "identifier": "P00404838",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64313646",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOSHA NPI",
            "identifier": "1285781682",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64094485",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TG LDC RR GRP",
            "identifier": "DD2844",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65946022",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TG ANTHEM LDC",
            "identifier": "000000545010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lexington Compounding Pharmacy, Inc. (Lexington Compounding Pharmacy)
• Lexington Counseling and Psychiatry, PLLC
• Lexington Dental Sleep Therapy, PLLC
• Lexington Dermatology & Laser Center PSC
• Lexington Diabetic Center PSC
• Lexington Diabetic Center, PSC
• Lexington Dialysis LLC (Hamburg Dialysis)
• Lexington Disc & Wellness Institute Functional Nutrition-Chiropractic
• Lexington Disc & Wellness Medical-Nutrition-Aubrey Chiropractic (Lexington Disc & Wellness Institute)
• Lexington Family Chiropractic PLLC

• Point of Service in Lexington, KY
• Providers in Lexington, KY by specialty
• Point of Service in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.