Central Kentucky Surgical Services LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

CENTRAL KENTUCKY SURGICAL SERVICES LLC

Practice address

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615

Phone

(270) 465-2521

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Susan A. Shively

Title

Owner

Phone

27014652521

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1689701997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 LEBANON AVE",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181809",
            "telephone_number": "270-465-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-465-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY SURGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "SHIVELY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "27014652521"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Drug Center
• Central Drug Center Inc.
• Central Kentucky Audiology, Inc
• Central Kentucky Surgical Institute
• Central Kentucky Surgical Institute, PSC
• Central Ky Hearing Care, Inc
• Century Pharmacy Inc (Century Medicines)
• Winit Chartisathian, M.D.
• Christian Care Communities, Inc. (Pathways of Central Kentucky)
• City of Campbellsville Ky (Campbellsville Taylor County EMS)

• Nurse Practitioner in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.