Southern Kentucky Heart Institute,PSC

Primary specialty

SpecialistTaxonomy code 174400000X

License

42271 Issued in KY

Legal business name

SOUTHERN KENTUCKY HEART INSTITUTE,PSC

Practice address

1848 Lyda Ave
Bowling Green, KY 42104-3361

Phone

(270) 495-1484

Fax

(270) 495-1488

NPI assigned

Sep 6, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Frank T Schwender I, M.D.NPI 1700098290

Title

Owner

Phone

(901) 590-8632

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank T Schwender, MD

  • Clinical Cardiac Electrophysiology Physician
  • Bowling Green, KY
  • NPI 1700098290
  Medicare reassignment NPD Authorized official
• Brianah L Doeden, APRN

  • Family Nurse Practitioner
  • Alvaton, KY
  • NPI 1841211356
  NPD (past)
• Demara Andrea Goodrich, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
  • NPI 1023394442
  NPD (past)
• James Marvin Staples, ARNP

  • Family Nurse Practitioner
  • Auburn, KY
  • NPI 1386751709
  NPD (past)
• Stacia Ashley Staples, ARNP

  • Family Nurse Practitioner
  • Auburn, KY
  • NPI 1851549422
  NPD (past)

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1386079556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 LYDA AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043361",
            "telephone_number": "270-495-1484",
            "fax_number": "270-495-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 LYDA AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043361",
            "telephone_number": "270-495-1484",
            "fax_number": "270-495-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KENTUCKY HEART INSTITUTE,PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-06",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "SCHWENDER",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-590-8632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "42271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100080740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.