Central Kentucky Surgical Institute, PSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

24667 Issued in KY

Legal business name

CENTRAL KENTUCKY SURGICAL INSTITUTE, PSC

Practice address

1878 Old Lebanon Rd
Campbellsville, KY 42718-9663

Phone

(270) 465-7505

Fax

(270) 789-3860

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David E Bentley, M.D., FACS

Title

President

Phone

(270) 465-7505

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1497970743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1114",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427191114",
            "telephone_number": "270-465-7505",
            "fax_number": "270-789-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1878 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189663",
            "telephone_number": "270-465-7505",
            "fax_number": "270-789-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY SURGICAL INSTITUTE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-465-7505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., FACS"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": "24667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64246671",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000062911",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Cecil, OTR
• Central Drug Center
• Central Drug Center Inc.
• Central Kentucky Audiology, Inc
• Central Kentucky Surgical Institute
• Central Kentucky Surgical Services LLC
• Central Ky Hearing Care, Inc
• Century Pharmacy Inc (Century Medicines)
• Winit Chartisathian, M.D.
• Christian Care Communities, Inc. (Pathways of Central Kentucky)

• Surgery Physician in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.