Crestwood Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02614 Issued in KY

Legal business name

CRESTWOOD FAMILY MEDICINE

Practice address

6106 Crestwood Sta Ste a
Crestwood, KY 40014-9473

Phone

(502) 243-3161

Fax

(502) 243-3164

NPI assigned

Jul 29, 2006

Last updated

Aug 22, 2020By 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. Richard Arthur Hefner, D.O.NPI 1639102585

Title

Owner

Phone

(502) 243-3161

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard A Hefner, D.O.

  • Family Medicine Physician
  • Crestwood, KY
  • NPI 1639102585
  Authorized official Same address or phone

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427063379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6106 CRESTWOOD STA STE A",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149473",
            "telephone_number": "502-243-3161",
            "fax_number": "502-243-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6106 CRESTWOOD STA STE A",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149473",
            "telephone_number": "502-243-3161",
            "fax_number": "502-243-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEFNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-243-3161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64000391",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kay Clegg
• Hailey Coffey, MS
• Tiffany Cole Hall, LCSW, LCADC
• Commonwealth of Kentucky (Windsong)
• Crestwood Chiropractic Group PSC
• Crestwood Integrative Health & Wellness Center
• Albert Lee Crush II, DMD
• Jaclyn Anne Crush, PT, DPT, WCS
• Laura Danielson, LCSW
• Joshua Brandon Darnell, PHARM.D.

• Family Medicine Physician in Crestwood, KY
• Providers in Crestwood, KY by specialty
• Family 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.