Individual provider Active NPI

Fareesh Hobbs Kanga, M.D.

  • Child & Adolescent Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1699938068
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
44133 Issued in KY
Practice address
496 Southland Dr
Lexington, KY 40503-1827
Phone
(859) 288-2425
Fax
(859) 288-7510
NPI assigned
Jul 7, 2008
Last updated
May 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 44133 KY
Child & Adolescent Psychiatry Physician 2084P0804X 35.120247 OH
Child & Adolescent Psychiatry Physician 2084P0804X 44133 KY Primary

Addresses

Primary practice location

496 Southland Dr
Lexington, KY 40503-1827

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2392

Other identifiers 1

IdentifierTypeStateIssuer
7100177700MedicaidKY

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
I20131120001665 KY Practitioner - Psychiatry 8022244169 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.120247OHMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthfirst Bluegrass Inc CurrentSince Sep 15, 2013 Accepting new patients
Kentucky Medical Services Foundation, Inc Psychiatry CurrentSince Mar 14, 2020 Accepting new patients
Healthfirst Bluegrass Inc. CurrentSince Sep 15, 2013 Accepting new patients
Healthfirst Bluegrass Inc PastSince Oct 1, 2019 Accepting new patients

Locations

1113 Centre Pkwy
Lexington, KY 40517
Phone (859) 381-3606

1640 Bryan Station Rd
#1
Lexington, KY 40505

1640 Bryan Station Rd
Ste 1
Lexington, KY 40505

218 Mandalay Rd
Lexington, KY 40504
Phone (859) 381-3340

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

245 Fountain Ct
Lexington, KY 40509
Phone (859) 323-6021

496 Southland Dr
Lexington, KY 40503
Phone (859) 288-2392

Interoperability endpoints

  • Direct secure messaging: fkanga32690@ukhcdirect.org

Organizations & group practices 4

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1699938068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2392",
            "fax_number": "859-721-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2425",
            "fax_number": "859-288-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGA",
        "first_name": "FAREESH",
        "middle_name": "HOBBS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "44133",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35.120247",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "44133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100177700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.