NPIMap

Organization Active NPI

Bluegrass Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Somerset, KY
National Provider Identifier
1558314534
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BLUEGRASS RADIOLOGY ASSOCIATES INC
Practice address
305 Langdon St
Somerset, KY 42503-2750
Phone
(606) 679-7441
Fax
(606) 678-9919
NPI assigned
May 18, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
William M Baker, MDNPI 1285671255
Title
President
Phone
(606) 679-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X KY Primary

Addresses

Primary practice location

305 Langdon St
Somerset, KY 42503-2750

Mailing address

PO Box 2425
Indianapolis, IN 46206-2425
Phone (866) 388-4129

Other identifiers 2

IdentifierTypeStateIssuer
000000059580OtherKYBCBS
6591689200MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL, GA, AL, SC, NV, TN7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20050726000033 KY Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 5 practitioners
Practice locations: Somerset, KY; Whitley City, KY; Paint Lick, KY; Nancy, KY; Monticello, KY; London, KY
O20220623000529 FL Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 5 practitioners
Practice locations: Poinciana, FL; Palm City, FL; Longwood, FL; Lakewood Ranch, FL; Jacksonville, FL; Fleming Island, FL
O20240102000895 GA Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 1 practitioner
Practice locations: Kennesaw, GA
O20240102001799 AL Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 3 practitioners
Practice locations: Auburn, AL; Montgomery, AL; Theodore, AL
O20241009002696 SC Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, SC
O20250106001467 NV Part B Supplier - Clinic/Group Practice 4284661836 Practice locations: Las Vegas, NV
O20250430002287 TN Part B Supplier - Clinic/Group Practice 4284661836 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

148 London Mountain View Dr
#D1
London, KY 40741
Phone (606) 877-2840

340 Bogle St
Somerset, KY 42503
Phone (606) 678-5137

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1558314534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2425",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062425",
            "telephone_number": "866-388-4129",
            "fax_number": "866-505-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-679-7441",
            "fax_number": "606-678-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS RADIOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-679-7441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000059580",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6591689200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.