Individual provider Active NPI

Nathan Lundy

  • Physical Therapist
  • London, KY
National Provider Identifier
1487460580
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009213 Issued in KY
Practice address
195 Commercial Dr Ste 100
London, KY 40744-5234
Phone
(606) 657-5111
NPI assigned
Dec 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 009213 KY Primary

Addresses

Primary practice location

195 Commercial Dr Ste 100
London, KY 40744-5234

Mailing address

195 Commercial Dr Ste 100
London, KY 40744-5234

Other practice location 1

1480 Cumberland Falls Hwy
Corbin, KY 40701-2721
Phone (606) 528-0870

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109003240 KY Practitioner - Physical Therapist in Private Practice 2769910348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revolution Physical TherapyGroup PAC ID 6507106812, 4 clinicians

Practice addresses (Care Compare)

195 Commercial Dr
Suite 100
London, KY 40744-5234
Phone (606) 524-7818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009213KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution Physical Therapy Corbin Physical Therapist CurrentSince Dec 15, 2024 Accepting new patients
Revolution Physical Therapy Physical Therapist CurrentSince Dec 15, 2024 Accepting new patients
Southeastern Kentucky Physical Therapy Clinic Inc Past Accepting new patients

Locations

1480 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 528-0870

195 Commercial Dr
Ste 100
London, KY 40744
Phone (606) 524-7818

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.

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1487460580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 COMMERCIAL DR STE 100",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407445234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 COMMERCIAL DR STE 100",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407445234",
            "telephone_number": "606-657-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 Cumberland Falls Hwy",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407012721",
            "country_code": "US",
            "telephone_number": "606-528-0870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDY",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "009213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.