Organization Active NPI

SJL Physician Management Services Inc.

Doing business as dba Premier Heart and Vascular Centers

  • Cardiovascular Disease Physician
  • London, KY
National Provider Identifier
1710115175
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SJL PHYSICIAN MANAGEMENT SERVICES INC.
Doing business as
dba Premier Heart and Vascular Centers
Practice address
1210 W 5TH St
London, KY 40741-2112
Phone
(606) 864-4040
Fax
(606) 864-3500
NPI assigned
Jun 24, 2009
Last updated
Feb 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Authorized official

Name
Carmel Jones, CPA
Title
VP Revenue Cycle & Business Service
Phone
(606) 877-3918

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X KY
Nurse Practitioner 363L00000X KY
Cardiovascular Disease Physician 207RC0000X KY Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X KY
Interventional Cardiology Physician 207RI0011X KY

Addresses

Primary practice location

1210 W 5TH St
London, KY 40741-2112

Mailing address

PO Box 2638
London, KY 40743-2638
Phone (606) 864-4040

Other identifiers 2

IdentifierTypeStateIssuer
C21207OtherKYCHI
000000638615OtherKYANTHEM BCBS PIN

Other names 1

  • dba Premier Heart and Vascular Centers Doing business as

National Provider Directory

National Provider Directory

Locations

215 Treuhaft Blvd
Barbourville, KY 40906
Phone (606) 545-0400

1707 Cumberland Falls Hwy
#113
Corbin, KY 40701
Phone (606) 528-2459

192 London Shopping Ctr
#3
London, KY 40741
Phone (606) 330-2361

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1710115175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2638",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407432638",
            "telephone_number": "606-864-4040",
            "fax_number": "606-877-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 5TH ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407412112",
            "telephone_number": "606-864-4040",
            "fax_number": "606-864-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJL PHYSICIAN MANAGEMENT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CARMEL",
        "authorized_official_title_or_position": "VP REVENUE CYCLE & BUSINESS SERVICE",
        "authorized_official_telephone_number": "606-877-3918",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHI",
            "identifier": "C21207",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PIN",
            "identifier": "000000638615",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Premier Heart and Vascular Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.