Individual provider Active NPI

Edward Terutaka Murdock, DO

  • Emergency Medicine Physician
  • Lexington, KY
National Provider Identifier
1366456386
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
06453 Issued in IA
Practice address
150 N Eagle Creek Dr
Lexington, KY 40509-1805
Phone
(859) 967-5176
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34008670 OH
Emergency Medicine Physician 207P00000X 03163 KY
Emergency Medicine Physician 207P00000X 06453 IA Primary

Addresses

Primary practice location

150 N Eagle Creek Dr
Lexington, KY 40509-1805

Mailing address

3156 Hemingway LN
Lexington, KY 40513-1858
Phone (859) 309-9545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803002482 IA Practitioner - Emergency Medicine 1658377379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
06453IAMDChiropractor
34008670OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Health System, Inc. Past Accepting new patients
Saint Joseph Health System, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1366456386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 HEMINGWAY LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131858",
            "telephone_number": "859-309-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091805",
            "telephone_number": "859-967-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "EDWARD",
        "middle_name": "TERUTAKA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34008670",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "03163",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "06453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.