Active NPI
Marcus Patton, MD
- Anesthesiology Physician
- Bowling Green, KY
National Provider Identifier
1710974324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 15539
- Practice address
- 1725 Ashley Cir
Suite 209a
Bowling Green, KY 42104-3337 - Phone
- (270) 782-9994
- Fax
- (270) 842-5048
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 15539 | KY | Primary |
Addresses
Primary practice location
1725 Ashley Cir
Suite 209a
Bowling Green, KY 42104-3337
Mailing address
PO Box 2020
Bowling Green, KY 42102-2020
Phone (270) 782-9994
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64155393 | Medicaid | KY |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15539 | KY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1710974324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2020",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421022020",
"telephone_number": "270-782-9994",
"fax_number": "270-842-5048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 ASHLEY CIR",
"address_2": "SUITE 209A",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043337",
"telephone_number": "270-782-9994",
"fax_number": "270-842-5048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTON",
"first_name": "MARCUS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KY",
"license": "15539",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64155393",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.