Individual provider Active NPI

David Wayne Flynn, M.D.

  • Family Medicine Physician
  • Somerset, KY
National Provider Identifier
1700889144
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31204 Issued in KY
Practice address
305 Langdon St
Somerset, KY 42503-2750
Phone
(606) 679-7441
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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 31204 KY Primary

Addresses

Primary practice location

305 Langdon St
Somerset, KY 42503-2750

Mailing address

1276 Wolf Creek Rd
Nancy, KY 42544-6621
Phone (606) 875-4262

Other identifiers 2

IdentifierTypeStateIssuer
000000189023OtherKYANTHEM ID NUMBER
65933749MedicaidKY

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
I20071026000375 KY Practitioner - Family Practice 0143317917 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional Hospital LLC Family Medicine Current Accepting new patients
Lake Cumberland Regional Hospital, LLC Family Medicine CurrentSince Jan 1, 1999 Accepting new patients
Lake Cumberland Regional Hospital LLC CurrentSince Jan 1, 1999 Accepting new patients
Flynn and Petrosky PSC Family Medicine Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

350 Hospital Way
Ste 100
Somerset, KY 42503
Phone (606) 451-2600

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

Organizations & group practices 5

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1700889144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 WOLF CREEK RD",
            "city": "NANCY",
            "state": "KY",
            "postal_code": "425446621",
            "telephone_number": "606-875-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-679-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "31204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID NUMBER",
            "identifier": "000000189023",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65933749",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.