Individual provider Active NPI

Tina Denise Fawns, MD

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1417904293
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37312 Issued in KY
Practice address
2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504
Phone
(859) 323-6371
Fax
(859) 323-6661
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37312 KY Primary

Addresses

Primary practice location

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504

Mailing address

2195 Harrodsburg Rd
Suite 125
Lexington, KY 40504
Phone (859) 323-6712

Other identifiers 3

IdentifierTypeStateIssuer
2619152MedicaidOH
3810003773MedicaidWV
64068117MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000774 KY Practitioner - Family Practice 9436131158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

100 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 257-9800

2400 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 323-7426

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Family Medicine CurrentSince Mar 11, 2016 Accepting new patients
St. Claire Medical Center, Inc Past Accepting new patients
St. Claire Medical Center Inc. Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

2195 Harrodsburg Rd
Ste 125
Lexington, KY 40504
Phone (859) 257-4732

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

2195 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 323-2232

234 Medical Cir
Morehead, KY 40351
Phone (606) 784-6641

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

632 Slate Ave
Owingsville, KY 40360
Phone (606) 674-6386

Interoperability endpoints

  • Direct secure messaging: tfawns32800@ukhcdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1417904293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 HARRODSBURG RD",
            "address_2": "SUITE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-323-6712",
            "fax_number": "859-323-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 HARRODSBURG RD STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043504",
            "telephone_number": "859-323-6371",
            "fax_number": "859-323-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWNS",
        "first_name": "TINA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "37312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2619152",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003773",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64068117",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.