Active NPI
Marymount Medical Center Physician Services
Doing business as Pulmonary & Sleep Specialists of London
- Pulmonary Disease Physician
- London, KY
National Provider Identifier
1619200151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- Legal business name
- MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
- Doing business as
- Pulmonary & Sleep Specialists of London
- Practice address
- 1210 W 5TH St
London, KY 40741-2112 - Phone
- (606) 864-4030
- Fax
- (606) 864-0115
- NPI assigned
- Sep 16, 2009
- Organization subpart
- Yes
- Parent organization
- MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kandi R Rea
- Title
- Credentialing Specialist
- Phone
- (606) 330-3404
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | Primary |
Addresses
Primary practice location
1210 W 5TH St
London, KY 40741-2112
Mailing address
PO Box 2638
London, KY 40743-2638
Phone (606) 330-3404
Other names 1
- Pulmonary & Sleep Specialists of London
National Provider Directory
National Provider Directory- Part of
- Marymount Medical Center Physician Services
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1253145600000",
"number": "1619200151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2638",
"city": "LONDON",
"state": "KY",
"postal_code": "407432638",
"telephone_number": "606-330-3404",
"fax_number": "606-330-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 W 5TH ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407412112",
"telephone_number": "606-864-4030",
"fax_number": "606-864-0115"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES",
"enumeration_date": "2009-09-16",
"last_updated": "2009-09-17",
"status": "A",
"authorized_official_last_name": "REA",
"authorized_official_first_name": "KANDI",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "606-330-3404"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Pulmonary & Sleep Specialists of London",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in London, KY
- Virginia Ann Marcum, APRN
- Briana Nicole Martin
- Marymount Medical Center Physician Services
- Marymount Medical Center Physician Services (MMC Physician Services)
- Marymount Medical Center Physician Services (London Cardio-Vascular Surgery)
- Marymount Medical Center Physician Services
- Marymount Medical Center Physician Services
- Antwon Mason, LMT
- Amanda Baker Mastin, PHARMD
- Jackie D Maxey, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.