Individual provider Active NPI

Marc Henry Plavin, PH.D.

  • Psychologist
  • Lexington, KY
National Provider Identifier
1568425502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0648 Issued in KY
Practice address
3175 Custer Dr
Suite #200
Lexington, KY 40517-4023
Phone
(859) 273-1288
Fax
(859) 273-1278
NPI assigned
Apr 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0648 KY Primary

Addresses

Primary practice location

3175 Custer Dr
Suite #200
Lexington, KY 40517-4023

Mailing address

3175 Custer Dr
Suite #200
Lexington, KY 40517-4023
Phone (859) 273-1288

Other identifiers 1

IdentifierTypeStateIssuer
89006480MedicaidKY

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates PastSince Feb 1, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568425502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 CUSTER DR",
            "address_2": "SUITE #200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174023",
            "telephone_number": "859-273-1288",
            "fax_number": "859-273-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 CUSTER DR",
            "address_2": "SUITE #200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174023",
            "telephone_number": "859-273-1288",
            "fax_number": "859-273-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAVIN",
        "first_name": "MARC",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "0648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89006480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.