Individual provider Active NPI

Christian D Konsavage, M.D.

  • Family Medicine Physician
  • Burkesville, KY
National Provider Identifier
1609802347
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
KY37254 Issued in KY
Practice address
299A Glasgow Rd
Burkesville, KY 42717-9696
Phone
(270) 864-2555
Fax
(270) 864-3777
NPI assigned
Jun 24, 2006
Last updated
Jan 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X KY37254 KY Primary

Addresses

Primary practice location

299A Glasgow Rd
Burkesville, KY 42717-9696

Mailing address

896 Potters Creek Rd
Burkesville, KY 42717-7638
Phone (270) 433-6475

Other identifiers 2

IdentifierTypeStateIssuer
64058860MedicaidKY
0176477OtherKYBLUE CROSS

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000185 KY Practitioner - Family Practice 6507754017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

299 Glasgow Rd
Burkesville, KY 42717-9696
Phone (270) 864-2511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.47 of 100Reported as group
Quality
85.04
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
KY37254KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital Association Inc Family Medicine CurrentSince Nov 1, 2002 Accepting new patients
Cumberland County Hospital Association Inc CurrentSince Nov 1, 2002 Accepting new patients
Cumberland County Hospital Association Inc Past Accepting new patients

Locations

299 Glasgow Rd
Burkesville, KY 42717
Phone (270) 864-2511

299A Glasgow Rd
Burkesville, KY 42717
Phone (270) 864-2555

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1609802347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 POTTERS CREEK RD",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427177638",
            "telephone_number": "270-433-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299A GLASGOW RD",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427179696",
            "telephone_number": "270-864-2555",
            "fax_number": "270-864-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONSAVAGE",
        "first_name": "CHRISTIAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "KY37254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64058860",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0176477",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burkesville, KY

Sources for this page

Verify at the official NPI Registry.