Bluegrass Vein Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUEGRASS VEIN CLINIC

Practice address

201 Professional Park Dr
Glasgow, KY 42141-3486

Phone

(270) 392-3661

Fax

(580) 297-9310

NPI assigned

Jun 25, 2020

Last updated

Nov 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie Schoenbaechler

Title

Credentialing Specialist

Phone

(502) 220-8437

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1508483512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 TRIGG CT",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421412252",
            "telephone_number": "270-392-3661",
            "fax_number": "580-297-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PROFESSIONAL PARK DR",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413486",
            "telephone_number": "270-392-3661",
            "fax_number": "580-297-9310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 Woodhurst St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421043358",
            "country_code": "US",
            "telephone_number": "270-392-3661",
            "fax_number": "580-297-9310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUEGRASS VEIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "SCHOENBAECHLER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "502-220-8437"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.