Individual provider Active NPI

Sundiata M El-Amin, MD

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1760440655
Registry record updated Dec 18, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Jun 20, 2019.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21770 Issued in KY
Practice address
557 Wellington Gardens Dr
Lexington, KY 40503-3477
Phone
(859) 402-1517
NPI assigned
May 2, 2006
Last updated
Dec 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21770 KY Primary

Addresses

Primary practice location

557 Wellington Gardens Dr
Lexington, KY 40503-3477

Mailing address

557 Wellington Gardens Dr
Lexington, KY 40503-3477
Phone (859) 402-1517

Other identifiers 1

IdentifierTypeStateIssuer
21770OtherKYMEDICAL LIC

Other names 1

  • Mr. Cephas G Jackson Sr. Former name

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21770KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jenkins Healthcare Company Inc Past Accepting new patients
Jenkins Community Hospital Dba Jenkins Community Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1760440655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 WELLINGTON GARDENS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033477",
            "telephone_number": "859-402-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 WELLINGTON GARDENS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033477",
            "telephone_number": "859-402-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-AMIN",
        "first_name": "SUNDIATA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "21770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "21770",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CEPHAS",
            "last_name": "JACKSON",
            "middle_name": "G",
            "prefix": "MR.",
            "suffix": "SR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.