NPIMap

Organization Active NPI

Kings Daughters Medical Specialties Interventional Spine

  • Pain Medicine (Anesthesiology) Physician
  • Ashland, KY
National Provider Identifier
1740763945
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
KINGS DAUGHTERS MEDICAL SPECIALTIES INTERVENTIONAL SPINE
Practice address
617 23Rd St Ste 8B
Ashland, KY 41101-2845
Phone
(606) 408-1290
Fax
(606) 408-6640
NPI assigned
Sep 13, 2018
Last updated
Oct 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Kristie Whitlatch
Title
Ceo/Presdient
Phone
(606) 408-4401

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Chiropractor 111N00000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Nurse Practitioner 363L00000X NU
Pediatric Anesthesiology Physician 207LP3000X NU

Addresses

Primary practice location

617 23Rd St Ste 8B
Ashland, KY 41101-2845

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-1290

Other practice location 1

617 23rd St Ste 320
Ashland, KY 41101-2880
Phone (606) 408-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100114000813 OH Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 181 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wheelersburg, OH; Waverly, OH; South Point, OH; Portsmouth, OH; Lucasville, OH; Jackson, OH; Ironton, OH; Franklin Furance, OH
O20100217000538 KY Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 554 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Kings Daughters Medical Specialties Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

617 23rd St
Ste 8B
Ashland, KY 41101
Phone (606) 408-1290

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1740763945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-1290",
            "fax_number": "606-408-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 8B",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012845",
            "telephone_number": "606-408-1290",
            "fax_number": "606-408-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 23rd St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411012880",
            "country_code": "US",
            "telephone_number": "606-408-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINGS DAUGHTERS MEDICAL SPECIALTIES INTERVENTIONAL SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "WHITLATCH",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "CEO/PRESDIENT",
        "authorized_official_telephone_number": "606-408-4401"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.