Individual provider Active NPI

Erika D Dallas, M.D.

  • Family Medicine Physician
  • Paducah, KY
National Provider Identifier
1366518060
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35228 Issued in KY
Practice address
4645 Village Square Drive
Suite a
Paducah, KY 42001-5252
Phone
(270) 444-9934
Fax
(270) 444-9937
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35228 KY Primary

Addresses

Primary practice location

4645 Village Square Drive
Suite a
Paducah, KY 42001-5252

Mailing address

4645 Village Square Drive
Suite a
Paducah, KY 42001-5252
Phone (270) 444-9934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Ophthalmology Group, LLC CurrentSince Aug 1, 2016 Accepting new patients
Major Hospital Past Accepting new patients

Locations

4630 Village Square Dr
Paducah, KY 42001
Phone (270) 442-1671

4630 Village Square Dr
Ste 102
Paducah, KY 42001
Phone (270) 443-4393

Organizations & group practices 2

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366518060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 VILLAGE SQUARE DRIVE",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015252",
            "telephone_number": "270-444-9934",
            "fax_number": "270-444-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 VILLAGE SQUARE DRIVE",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015252",
            "telephone_number": "270-444-9934",
            "fax_number": "270-444-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "ERIKA",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "35228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.