Internal Medicine Associates of Ky PSC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

39044 Issued in KY

Legal business name

INTERNAL MEDICINE ASSOCIATES OF KY PSC

Doing business as

Internal Medicine Associates of KY PSC

Practice address

2135 Highway 30 Byp
Suite 1
London, KY 40741-6139

Phone

(606) 864-2179

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gina Dcosta, MD

Title

Doctor

Phone

(606) 864-2179

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Internal Medicine Associates of KY PSC Doing business as

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396774048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 HIGHWAY 30 BYP",
            "address_2": "SUITE 1",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416139",
            "telephone_number": "606-864-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 HIGHWAY 30 BYP",
            "address_2": "SUITE 1",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416139",
            "telephone_number": "606-864-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF KY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DCOSTA",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "606-864-2179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "KY",
            "license": "39044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64094576",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine Associates of KY PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Loren Imhoff, CSW
• Infectious Diseases of Kentucky, LLC
• Inspired Living
• Inspired Living, LLC
• Internal Medicine Associates of Ky PSC
• Caroline Michelle Jackson, PA-C
• Kayla Jackson, SLP
• Matthew Aaron Jackson
• Laceysha Jamison, LPCA
• Janus RX LLC

• Geriatric Medicine (Internal Medicine) Physician in London, KY
• Providers in London, KY by specialty
• Geriatric Medicine (Internal Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.