Organization Active NPI

Allergy Asthma & Immunology Center, LLC

  • Allergy & Immunology Physician
  • Somerset, KY
National Provider Identifier
1467622167
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ALLERGY ASTHMA & IMMUNOLOGY CENTER, LLC
Practice address
110 Hardin LN Ste 3
Somerset, KY 42503-3818
Phone
(606) 451-0115
Fax
(606) 451-0155
NPI assigned
Mar 10, 2008
Last updated
Jul 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Authorized official

Name
Sanaa A Mahmoud, MDNPI 1174527956
Title
Owner
Phone
(606) 451-0115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X KY Primary

Addresses

Primary practice location

110 Hardin LN Ste 3
Somerset, KY 42503-3818

Mailing address

110 Hardin LN Ste 3
Somerset, KY 42503-3818
Phone (606) 451-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308000645 KY Part B Supplier - Clinic/Group Practice 9234183716 Receives reassigned benefits from 1 practitioner
Practice locations: Somerset, KY

National Provider Directory

National Provider Directory

Locations

110 Hardin Ln
Ste 3
Somerset, KY 42503
Phone (606) 451-0115

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1467622167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN STE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0115",
            "fax_number": "606-451-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN STE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-0115",
            "fax_number": "606-451-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY ASTHMA & IMMUNOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "MAHMOUD",
        "authorized_official_first_name": "SANAA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-451-0115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.