Organization Active NPI

Landmark Medical of Kentucky, PSC

  • General Practice Physician
  • Lexington, KY
National Provider Identifier
1649775586
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LANDMARK MEDICAL OF KENTUCKY, PSC
Practice address
113 Glenn PL Unit 100
Lexington, KY 40505-3518
Phone
(657) 400-5180
NPI assigned
Mar 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Christopher Dennus, MD
Title
Chief Medical Officer
Phone
(657) 400-5180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

113 Glenn PL Unit 100
Lexington, KY 40505-3518

Mailing address

7755 Center Ave Ste 630
Huntington Beach, CA 92647-9152
Phone (657) 400-5180

National Provider Directory

National Provider Directory

Locations

9390 Bunsen Pkwy
Louisville, KY 40220
Phone (833) 358-2278

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1649775586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 CENTER AVE STE 630",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926479152",
            "telephone_number": "657-400-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GLENN PL UNIT 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405053518",
            "telephone_number": "657-400-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK MEDICAL OF KENTUCKY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "DENNUS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "657-400-5180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 30, 2024; 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.