Patriot One Primary Care PSC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

PATRIOT ONE PRIMARY CARE PSC

Practice address

989 Governors LN Ste 220
Lexington, KY 40513-1175

Phone

(859) 447-8014

Fax

(859) 447-8013

NPI assigned

May 4, 2022

Last updated

Aug 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Mentzer, PA-CNPI 1578889663

Title

Owner

Phone

(859) 447-8014

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth K Mentzer, PA-C

  • Physician Assistant
  • Lexington, KY
  • NPI 1578889663
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1699410548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 220",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-447-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 220",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-447-8014",
            "fax_number": "859-447-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT ONE PRIMARY CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-08-02",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "MENTZER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-447-8014",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100137000",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kareo",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "989 Governors Ln Ste 220",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405131175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Patrick
• Sondra Stratton Patrick, RPH
• Taylor H Patrick, MD
• Tracey Patrick, RDN, LD
• Patriot One Primary Care PSC
• Samantha Patrize
• Tamara F Patsey, MD
• Alexander Patterson, MD
• Donna Patterson
• Jane Kelly Patterson

• Medical Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.