Active NPI
Reynaldo A Carnero, M.D.
- Psychiatry Physician
- Lexington, KY
National Provider Identifier
1629091095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 22175
- Practice address
- 627 W Fourth St
Eastern State Hospital
Lexington, KY 40508-1294 - Phone
- (859) 246-7000
- Fax
- (859) 246-7023
- NPI assigned
- Jul 25, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 22175 | KY | Primary |
Addresses
Primary practice location
627 W Fourth St
Eastern State Hospital
Lexington, KY 40508-1294
Mailing address
627 W Fourth St
Eastern State Hospital
Lexington, KY 40508-1294
Phone (859) 246-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22175 | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth of Kentucky | Past | Accepting new patients | |
| Commonwealth of Kentucky | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Somerset, KY
- NPI 1245657857
-
- Psychiatric Hospital
- Lexington, KY
- NPI 1790816395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1629091095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "627 W FOURTH ST",
"address_2": "EASTERN STATE HOSPITAL",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405081294",
"telephone_number": "859-246-7000",
"fax_number": "859-246-7023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "627 W FOURTH ST",
"address_2": "EASTERN STATE HOSPITAL",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405081294",
"telephone_number": "859-246-7000",
"fax_number": "859-246-7023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNERO",
"first_name": "REYNALDO",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KY",
"license": "22175",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22175",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.