Active NPI
Ronald M Kupper, M.D.
- Urology Physician
- Paducah, KY
National Provider Identifier
1629070701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 15524
- Practice address
- 2603 Kentucky Ave
Ste 102
Paducah, KY 42003-3815 - Phone
- (270) 442-3539
- Fax
- (270) 442-2051
- NPI assigned
- Jun 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 15524 | KY | Primary |
Addresses
Primary practice location
2603 Kentucky Ave
Ste 102
Paducah, KY 42003-3815
Mailing address
2603 Kentucky Ave
Ste 102
Paducah, KY 42003-3815
Phone (270) 442-3539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64155245 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261440000000",
"number": "1629070701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2603 KENTUCKY AVE",
"address_2": "STE 102",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420033815",
"telephone_number": "270-442-3539",
"fax_number": "270-442-2051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2603 KENTUCKY AVE",
"address_2": "STE 102",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420033815",
"telephone_number": "270-442-3539",
"fax_number": "270-442-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPPER",
"first_name": "RONALD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2009-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KY",
"license": "15524",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64155245",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.