NPIMap

Organization Active NPI

Kentucky Mso LLC

Doing business as Bluegrass Pediatrics and Internal Medicine-Georgetown

  • Pediatrics Physician
  • Georgetown, KY
National Provider Identifier
1568907798
Registry record updated Dec 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KENTUCKY MSO LLC
Doing business as
Bluegrass Pediatrics and Internal Medicine-Georgetown
Practice address
196 Bevins LN
Suite F
Georgetown, KY 40324-8534
Phone
(502) 863-2818
Fax
(502) 863-2764
NPI assigned
Dec 26, 2016
Last updated
Dec 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2016

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

Authorized official

Name
Sara Miller
Title
Director
Phone
(615) 920-7514

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

196 Bevins LN
Suite F
Georgetown, KY 40324-8534

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Bluegrass Pediatrics and Internal Medicine-Georgetown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bluegrass Family Care Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1482710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482710400000",
    "number": "1568907798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 BEVINS LN",
            "address_2": "SUITE F",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248534",
            "telephone_number": "502-863-2818",
            "fax_number": "502-863-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY MSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-26",
        "last_updated": "2016-12-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7514"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluegrass Pediatrics and Internal Medicine-Georgetown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2016; 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.