Organization Active NPI

S.H.K.Reddy,MD,PSC.,

  • Ophthalmology Physician
  • Hazard, KY
National Provider Identifier
1720264971
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
S.H.K.REDDY,MD,PSC.,
Practice address
200 Medical Center Dr
Suite 3a
Hazard, KY 41701-9466
Phone
(606) 439-4767
Fax
(606) 439-4768
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Dr. Syamala H.K. Reddy, M.D.,
Title
Owner
Phone
(606) 439-4767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

200 Medical Center Dr
Suite 3a
Hazard, KY 41701-9466

Mailing address

200 Medical Center Dr
Suite 3a
Hazard, KY 41701-9466
Phone (606) 439-4767

Other identifiers 2

IdentifierTypeStateIssuer
0847OtherKYBLUE CROSS & BLUE SHIELD
64209224MedicaidKY

National Provider Directory

National Provider Directory

Locations

200 Medical Center Dr
Ste 3A
Hazard, KY 41701
Phone (606) 439-4767

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1720264971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR",
            "address_2": "SUITE 3A",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019466",
            "telephone_number": "606-439-4767",
            "fax_number": "606-439-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR",
            "address_2": "SUITE 3A",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019466",
            "telephone_number": "606-439-4767",
            "fax_number": "606-439-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.H.K.REDDY,MD,PSC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SYAMALA",
        "authorized_official_middle_name": "H.K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-439-4767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "0847",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64209224",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.