Active NPI
Jack Thomas Giannini, PSC
- Surgery Physician
- Hopkinsville, KY
National Provider Identifier
1447213897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 15869
- Practice address
- 220 W 18TH St
Hopkinsville, KY 42240-1963 - Phone
- (270) 886-7512
- Fax
- (270) 886-0174
- NPI assigned
- Apr 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 15869 | KY | Primary |
Addresses
Primary practice location
220 W 18TH St
Hopkinsville, KY 42240-1963
Mailing address
220 W 18TH St
Hopkinsville, KY 42240-1963
Phone (270) 886-7512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64158694 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15869 | KY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407110400000",
"number": "1447213897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W 18TH ST",
"city": "HOPKINSVILLE",
"state": "KY",
"postal_code": "422401963",
"telephone_number": "270-886-7512",
"fax_number": "270-886-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W 18TH ST",
"city": "HOPKINSVILLE",
"state": "KY",
"postal_code": "422401963",
"telephone_number": "270-886-7512",
"fax_number": "270-886-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIANNINI",
"first_name": "JACK",
"middle_name": "THOMAS",
"credential": "PSC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-07",
"last_updated": "2014-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "15869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64158694",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hopkinsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.