Individual provider Active NPI

John D. Ammon, M.D.

  • Family Medicine Physician
  • Burlington, KY
National Provider Identifier
1629139829
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13871 Issued in KY
Practice address
3901 Petersburg Rd
Burlington, KY 41005-8786
Phone
(859) 689-4791
NPI assigned
Dec 12, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13871 KY Primary
Family Medicine Physician 207Q00000X 35029763A OH
Family Medicine Physician 207Q00000X 36019 FL
Family Medicine Physician 207Q00000X 3676 AK

Addresses

Primary practice location

3901 Petersburg Rd
Burlington, KY 41005-8786

Mailing address

3901 Petersburg Rd
Burlington, KY 41005-8786
Phone (859) 689-4791

Other identifiers 1

IdentifierTypeStateIssuer
64138712MedicaidKY

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36019FLMDFamily Medicine Physician
35029763AOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Urgent Care Offices Medical Group Inc PastSince Oct 1, 2003 Accepting new patients
University of Cincinnati Physicians Company, LLC Family Medicine Past Accepting new patients
CG Medical Associates Inc Family Medicine PastSince Dec 1, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629139829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PETERSBURG RD",
            "city": "BURLINGTON",
            "state": "KY",
            "postal_code": "410058786",
            "telephone_number": "859-689-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PETERSBURG RD",
            "city": "BURLINGTON",
            "state": "KY",
            "postal_code": "410058786",
            "telephone_number": "859-689-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMON",
        "first_name": "JOHN",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "13871",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35029763A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "36019",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3676",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64138712",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.