Sleep Source Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

15166 Issued in KY

Legal business name

SLEEP SOURCE INC

Practice address

585 Westport Rd # C
Elizabethtown, KY 42701-2949

Phone

(270) 234-0999

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Hogancamp, M.D.

Title

Medical Director

Phone

(270) 575-0080

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1366590804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 PARISA DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034584",
            "telephone_number": "270-575-0080",
            "fax_number": "270-575-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 WESTPORT RD # C",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012949",
            "telephone_number": "270-234-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP SOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "HOGANCAMP",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "270-575-0080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "15166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000324218",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "5316100003",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Sizemore, D.C.
• Chance Clabron Skaggs
• Melissa Skaggs, MS, CCC/SLP
• Christopher Skillman, APSS
• Sleep Management, LLC
• Polly Ann Slieff
• Teresa Sloan, APSS
• Linda Carol Smiley, LPCC
• Aleksander Raphael Smith, M.D.
• Bailey Smith

• All providers in Elizabethtown, KY
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.