Active NPI
Kentucky Hospital, LLC
- Diagnostic Radiology Physician
- Winchester, KY
National Provider Identifier
1386961753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- KENTUCKY HOSPITAL, LLC
- Practice address
- 175 Hospital Dr
Winchester, KY 40391-9591 - Phone
- (859) 745-3500
- Fax
- (859) 145-3450
- NPI assigned
- Apr 26, 2010
- 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
- Terrance Dillon
- Title
- Assistant Secretary
- Phone
- (502) 596-7220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
175 Hospital Dr
Winchester, KY 40391-9591
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000
Other names 1
- Clark Regional Medical Center Radiology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100811000003 | KY | Part B Supplier - Clinic/Group Practice | 4688614290 |
Receives reassigned benefits from 15 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Winchester, KY; Stanton, KY |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Winchester, KY
- NPI 1114282605
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1650585600000",
"number": "1386961753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274536",
"telephone_number": "615-920-7000",
"fax_number": "615-920-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 HOSPITAL DR",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403919591",
"telephone_number": "859-745-3500",
"fax_number": "859-145-3450"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKY HOSPITAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-04-26",
"last_updated": "2022-04-22",
"certification_date": "2022-04-22",
"status": "A",
"authorized_official_last_name": "DILLON",
"authorized_official_first_name": "TERRANCE",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "502-596-7220"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Clark Regional Medical Center Radiology",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Clark Regional Medical Center Radiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Winchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.