Kings Daughters Medical Specialties Inc
Organization Active NPI Otolaryngology Physician · Ashland, KY
NPI 1497083539 · NPPES record last updated Apr 6, 2022
Key facts
- NPI
- 1497083539
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- Legal business name
- KINGS DAUGHTERS MEDICAL SPECIALTIES INC
- Practice address
- 613 23Rd St
Ste 420
Ashland, KY 41101-2878 - Phone
- (606) 324-2600
- Fax
- (606) 324-2606
- NPI assigned
- Dec 1, 2009
- Organization subpart
- No
Authorized official
- Name
- Kristie Whitlatch
- Title
- Ceo/President
- Phone
- (606) 408-4401
Other NPIs on the same Medicare enrollment 33
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 22
Practitioners 457
-
Omran Riad Abul-Khoudoud, MD, FACS, RVT
-
Susan Aliff, APRN
-
Hala M Alshayeb, MD
-
Caitlin Elizabeth Arthur, APRN, AGACNP-BC
-
Gregory L. Baker, M.D.
-
Tracy L. Barnitz, CRNA
-
Karri Berlin, APRN
-
David Lawrence Bickett, MSN, APRN, FNP-C
-
Ashli Davett Bowling, APRN
-
Jon A. Brinkman, D.O.
-
Eric H Bronstein, M.D.
-
Frank E. Caines, CRNA
-
Jessica Collins, DO
-
Evan Franklin Condee, D.O.
-
Zane A Darnell, MD
-
David William Dockray, M.D.
-
Joseph M Dressel, CRNA
-
Basel Edris, MD
-
James W. Egel, MD
-
Ashlee Ann Eichenlaub, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Kings Daughters Medical Specialties Interventional Spine
Locations
1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | |||
| Otolaryngology Physician |
207Y00000X | KY | Yes | |
| Medical Physician Assistant |
363AM0700X | |||
| Nurse Practitioner |
363L00000X |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810016581 | Medicaid | WV | |
| 7100103050 | Medicaid | KY | |
| 9386361 | Medicaid | OH |
Other names
- Kings Daughters Medical Specialities ENT
Other providers in Ashland, KY
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
- Kings Daughters Medical Specialties Inc
All providers in Ashland, KY · Otolaryngology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.