Organization Active NPI

Heart Specialists of SE Ky PSC

  • Specialist
  • Corbin, KY
National Provider Identifier
1386752756
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
29557 Issued in KY
Legal business name
HEART SPECIALISTS OF SE KY PSC
Doing business as
Heart Specialists of SE Ky PSC
Practice address
45 Moonbow PLZ
Corbin, KY 40701-8949
Phone
(606) 523-9010
Fax
(606) 523-5923
NPI assigned
Aug 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Janie Renee Okuma
Title
Office Manager
Phone
(606) 523-9010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 29557 KY Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X PA249 KY
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 4069P KY

Addresses

Primary practice location

45 Moonbow PLZ
Corbin, KY 40701-8949

Mailing address

45 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 523-9010

Other identifiers 1

IdentifierTypeStateIssuer
65914996MedicaidKY

Other names 1

  • HEART SPECIALISTS OF SE KY PSC Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1386752756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MOONBOW PLZ",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018949",
            "telephone_number": "606-523-9010",
            "fax_number": "606-523-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MOONBOW PLZ",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018949",
            "telephone_number": "606-523-9010",
            "fax_number": "606-523-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART SPECIALISTS OF SE KY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "OKUMA",
        "authorized_official_first_name": "JANIE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-523-9010"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "29557",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA249",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4069P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65914996",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEART SPECIALISTS OF SE KY PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.