NPIMap

Organization Active NPI

Meadow Creek Surgical PLC

  • Surgical Physician Assistant
  • Rockholds, KY
National Provider Identifier
1366675886
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3428 Issued in KY
Legal business name
MEADOW CREEK SURGICAL PLC
Practice address
1420 Millertown Rd
Rockholds, KY 40759-7640
Phone
(606) 627-8575
NPI assigned
Sep 1, 2009
Last updated
Sep 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Authorized official

Name
Rickey Lee Melton, CSA / KCSANPI 1316906084
Title
President
Phone
(606) 627-8575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 3428 KY Primary

Addresses

Primary practice location

1420 Millertown Rd
Rockholds, KY 40759-7640

Mailing address

1420 Millertown Rd
Rockholds, KY 40759-7640
Phone (606) 627-8575

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251763200000",
    "number": "1366675886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 MILLERTOWN RD",
            "city": "ROCKHOLDS",
            "state": "KY",
            "postal_code": "407597640",
            "telephone_number": "606-627-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 MILLERTOWN RD",
            "city": "ROCKHOLDS",
            "state": "KY",
            "postal_code": "407597640",
            "telephone_number": "606-627-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOW CREEK SURGICAL PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2009-09-01",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "RICKEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-627-8575",
        "authorized_official_credential": "CSA / KCSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "3428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockholds, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; 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.