Blue Crescent-Blue Star Medical of Kentucky, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21770KY Issued in KY

Legal business name

BLUE CRESCENT-BLUE STAR MEDICAL OF KENTUCKY, INC

Practice address

95 S Main St
Dry Ridge, KY 41035-7343

Phone

(859) 823-0000

NPI assigned

Mar 17, 2011

Last updated

Mar 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sundiata M El-Amin, M.D.

Title

Owner

Phone

(859) 823-0000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1396044301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 S MAIN ST",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410357343",
            "telephone_number": "859-823-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S MAIN ST",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410357343",
            "telephone_number": "859-823-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CRESCENT-BLUE STAR MEDICAL OF KENTUCKY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "EL-AMIN",
        "authorized_official_first_name": "SUNDIATA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-823-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "21770KY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J Beach, D.P.M.
• Friend Bechtel, DMD
• Xiaomin Amy Benson
• Cassandra Best, RBT
• Jennifer Meek Blair, DMD
• Kristy Lyn Bosse, M.S., CCC/SLP
• Catherine Burke, LCSW
• Jonathan A Byers, MD
• Shelby Elizabeth Carmichael, DO
• Nissa C Carrier

• Internal Medicine Physician in Dry Ridge, KY
• Providers in Dry Ridge, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.