Pauline Ruth Siders, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3002633 Issued in KY

Practice address

3150 Custer Dr
Suite 201
Lexington, KY 40517-4010

Phone

(859) 229-0085

Fax

(859) 273-6778

NPI assigned

Nov 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Summit Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, KY
  • NPI 1609188689
  NPD (past)

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648944000000",
    "number": "1578890968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DR",
            "address_2": "SUITE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174010",
            "telephone_number": "859-327-1924",
            "fax_number": "859-273-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DR",
            "address_2": "SUITE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174010",
            "telephone_number": "859-229-0085",
            "fax_number": "859-273-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDERS",
        "first_name": "PAULINE",
        "middle_name": "RUTH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3002633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Sias, MD
• Nasir Hameed Siddiqi, MD
• Hammad Siddiqui, M.D
• Zohair Siddiqui, MD
• Christina Sideranko, NP
• Sally Gay Siebert, FNP PNP
• Adam Sieg, PHARMD
• Christopher James Siegel, MS, BCBA, LBA
• Meghan Siegrist, PA-C
• Melissa Lynn-Boian Siemer, AU.D.

• Psychiatric/Mental Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.