Individual provider Active NPI

Chenthan Krishnakumar, MD

  • Pediatric Gastroenterology Physician
  • Lexington, KY
National Provider Identifier
1619437290
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
TP458 Issued in KY
Practice address
740 S Limestone Ste K201
Lexington, KY 40536-4637
Phone
(859) 323-6211
Fax
(859) 257-0491
NPI assigned
Mar 21, 2019
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 39679 OK
Pediatric Gastroenterology Physician 2080P0206X TP458 KY Primary

Addresses

Primary practice location

740 S Limestone Ste K201
Lexington, KY 40536-4637

Mailing address

625 NW 182ND St
Edmond, OK 73012-4582
Phone (224) 302-2740

Other practice location 1

1200 Childrens Ave # 14400
Oklahoma City, OK 73104-4637
Phone (405) 271-5312

Other practice location 2

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-2345

Other identifiers 1

IdentifierTypeStateIssuer
6700889MedicaidVT

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
I20250627001523 KY Practitioner - Pediatric Medicine 7113250648 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39679OKMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jun 13, 2025 Accepting new patients
University of Kentucky CurrentSince Jun 13, 2025 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 2

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1619437290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 NW 182ND ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730124582",
            "telephone_number": "224-302-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE K201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364637",
            "telephone_number": "859-323-6211",
            "fax_number": "859-257-0491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Childrens Ave # 14400",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731044637",
            "country_code": "US",
            "telephone_number": "405-271-5312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNAKUMAR",
        "first_name": "CHENTHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OK",
            "license": "39679",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "KY",
            "license": "TP458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6700889",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.