Active NPI
Heart Specialists of SE Ky PSC
- Specialist
- Corbin, KY
National Provider Identifier
1386752756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 29557
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 29557 | KY | Primary |
| Physician Assistant | 363A00000X | PA249 | KY | |
| Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65914996 | Medicaid | KY |
Other names 1
- HEART SPECIALISTS OF SE KY PSC
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Corbin, KY
- NPI 1063417996
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.