Active NPI
Magen Renee Dye, APSS
- Peer Specialist
- Elizabethtown, KY
National Provider Identifier
1528895661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1213670
- Practice address
- 100 Diecks Dr
Elizabethtown, KY 42701-2443 - Phone
- (270) 982-1244
- NPI assigned
- Sep 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1213670 | KY | Primary |
Addresses
Primary practice location
100 Diecks Dr
Elizabethtown, KY 42701-2443
Mailing address
244 Emmaus Cir
Elizabethtown, KY 42701-4418
Phone (270) 312-5402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1213670 | KY | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1528895661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 EMMAUS CIR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427014418",
"telephone_number": "270-312-5402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DIECKS DR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012443",
"telephone_number": "270-982-1244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYE",
"first_name": "MAGEN",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "APSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-13",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "KY",
"license": "1213670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.