Individual provider Active NPI

David K. Kesheimer, P.A.-C,

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1689769457
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA213 Issued in KY
Practice address
700 Bob O Link Drive
Lexington, KY 40504
Phone
(859) 258-8575
Fax
(859) 258-8562
NPI assigned
Oct 4, 2006
Last updated
Nov 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA213 KY Primary
Medical Physician Assistant 363AM0700X PA213 KY
Surgical Physician Assistant 363AS0400X PA213 KY

Addresses

Primary practice location

700 Bob O Link Drive
Lexington, KY 40504

Mailing address

700 Bob O Link Drive
Lexington, KY 40504
Phone (859) 258-8575

Other identifiers 5

IdentifierTypeStateIssuer
95002135MedicaidKY
CB5773OtherGARR MEDICARE GROUP#
P00213321OtherGARR MEDICARE PIN#
37903705OtherKYMEDICAID LAB GROUP#
4000501OtherKYMEDICARE LAB GROUP#

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA213KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michael R. Heilig, M.D., PLLC Physician Assistant Past Accepting new patients

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1689769457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BOB O LINK DRIVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-258-8575",
            "fax_number": "859-258-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BOB O LINK DRIVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-258-8575",
            "fax_number": "859-258-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHEIMER",
        "first_name": "DAVID",
        "middle_name": "K.",
        "credential": "P.A.-C,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA213",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA213",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002135",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP#",
            "identifier": "CB5773",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN#",
            "identifier": "P00213321",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LAB GROUP#",
            "identifier": "37903705",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB GROUP#",
            "identifier": "4000501",
            "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 2, 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.