David Gerard Demar Sr., CSFA/KCSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

SA265 Issued in KY

Practice address

4305 New Shepherdsville Rd
Bardstown, KY 40004-9019

Phone

(502) 350-5521

NPI assigned

Jun 5, 2014

Last updated

Jun 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1376956516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 NEW SHEPHERDSVILLE RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400049019",
            "telephone_number": "502-350-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 NEW SHEPHERDSVILLE RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400049019",
            "telephone_number": "502-350-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAR",
        "first_name": "DAVID",
        "middle_name": "GERARD",
        "name_suffix": "Sr.",
        "credential": "CSFA/KCSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "SA265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.