NPIMap

Organization Active NPI

Kings Daughters Medical Specialties Inc

Doing business as Kings Daughters Medical Specialities ENT

  • Otolaryngology Physician
  • Ashland, KY
National Provider Identifier
1497083539
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
KINGS DAUGHTERS MEDICAL SPECIALTIES INC
Doing business as
Kings Daughters Medical Specialities ENT
Practice address
613 23Rd St
Ste 420
Ashland, KY 41101-2878
Phone
(606) 324-2600
Fax
(606) 324-2606
NPI assigned
Dec 1, 2009
Last updated
Apr 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Kristie Whitlatch
Title
Ceo/President
Phone
(606) 408-4401

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Nurse Practitioner 363L00000X
Internal Medicine Physician 207R00000X
Otolaryngology Physician 207Y00000X KY Primary

Addresses

Primary practice location

613 23Rd St
Ste 420
Ashland, KY 41101-2878

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other practice location 1

1729 Kinneys Ln Ste 201
Portsmouth, OH 45662-3167
Phone (740) 353-8100

Other identifiers 3

IdentifierTypeStateIssuer
9386361MedicaidOH
3810016581MedicaidWV
7100103050MedicaidKY

Other names 1

  • Kings Daughters Medical Specialities ENT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100114000813 OH Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 181 practitioners
24 other NPIs on this enrollment
Practice locations: Wheelersburg, OH; Waverly, OH; South Point, OH; Portsmouth, OH; Lucasville, OH; Jackson, OH; Ironton, OH; Franklin Furance, OH
O20100217000538 KY Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 554 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Kings Daughters Medical Specialties Interventional Spine23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1729 Kinneys Ln
Ste 201
Portsmouth, OH 45662
Phone (740) 353-8100

Practitioners & affiliated clinicians

Practitioners 191

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.

View all 191

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1497083539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST",
            "address_2": "STE 420",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012878",
            "telephone_number": "606-324-2600",
            "fax_number": "606-324-2606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1729 Kinneys Ln Ste 201",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456623167",
            "country_code": "US",
            "telephone_number": "740-353-8100",
            "fax_number": "740-353-8908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINGS DAUGHTERS MEDICAL SPECIALTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "WHITLATCH",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "606-408-4401"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9386361",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016581",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100103050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Daughters Medical Specialities ENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kings Daughters Medical Specialities ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.