Individual provider Active NPI

John Strother Belanger, MD

  • Family Medicine Physician
  • Paint Lick, KY
National Provider Identifier
1669517454
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26657 Issued in KY
Practice address
480 Main Street
Paint Lick, KY 40461
Phone
(859) 925-2444
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26657 KY Primary

Addresses

Primary practice location

480 Main Street
Paint Lick, KY 40461

Mailing address

1010 Main St S
MC Kee, KY 40447-7089
Phone (859) 626-7700

Other practice location 1

11652 Highway 52 E
Paint Lick, KY 40461-8454
Phone (859) 925-2444

Other identifiers 1

IdentifierTypeStateIssuer
64266570MedicaidKY

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
I20100720000395 KY Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 6507998036 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the East, PA Family Medicine CurrentSince Apr 29, 2019 Accepting new patients
Paint Lick Family Clinic Inc Family Medicine PastSince Sep 15, 2000 Accepting new patients

Locations

10200 Forest Green Blvd
Ste 112
Louisville, KY 40223
Phone (502) 214-5343

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1669517454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "859-626-7700",
            "fax_number": "859-626-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAIN STREET",
            "city": "PAINT LICK",
            "state": "KY",
            "postal_code": "40461",
            "telephone_number": "859-925-2444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11652 Highway 52 E",
            "address_purpose": "LOCATION",
            "city": "Paint Lick",
            "state": "KY",
            "postal_code": "404618454",
            "country_code": "US",
            "telephone_number": "859-925-2444",
            "fax_number": "859-925-2334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "JOHN",
        "middle_name": "STROTHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "26657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64266570",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paint Lick, KY

Sources for this page

Verify at the official NPI Registry.