Individual provider Active NPI

Taijha R Kleinmann, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1467824623
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2062 Issued in KY
Practice address
14949 N US Highway 25 E
Ste. 6
Corbin, KY 40701-6285
Phone
(606) 528-2160
Fax
(606) 528-2162
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2062 KY Primary

Addresses

Primary practice location

14949 N US Highway 25 E
Ste. 6
Corbin, KY 40701-6285

Mailing address

PO Box 1325
Corbin, KY 40702-1325
Phone (606) 526-8131

Other identifiers 2

IdentifierTypeStateIssuer
P01559923OtherKYRR MEDICARE
7100388950MedicaidKY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151116001555 KY Practitioner - Physician Assistant 7214247618 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8426
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2062KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince May 9, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 9, 2024 Accepting new patients

Locations

14949 N US Highway 25 E
Ste 6
Corbin, KY 40701
Phone (606) 528-2160

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

2 Trillium Way
Ste 106
Corbin, KY 40701
Phone (606) 526-4070

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1467824623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021325",
            "telephone_number": "606-526-8131",
            "fax_number": "606-528-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 N US HIGHWAY 25 E",
            "address_2": "STE. 6",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407016285",
            "telephone_number": "606-528-2160",
            "fax_number": "606-528-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMANN",
        "first_name": "TAIJHA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01559923",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100388950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.