Active NPI
Sundiata M El-Amin, MD
- Internal Medicine Physician
- Lexington, KY
National Provider Identifier
1760440655
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.
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21770
- Practice address
- 557 Wellington Gardens Dr
Lexington, KY 40503-3477 - Phone
- (859) 402-1517
- NPI assigned
- May 2, 2006
- Last updated
- Dec 18, 2008
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21770 | Other | KY | MEDICAL LIC |
Other names 1
- Mr. Cephas G Jackson Sr.
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21770 | KY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Clinic/Center
- Elkhorn City, KY
- NPI 1922143213
-
dba Jenkins Community Hospital
- Critical Access Hospital
- Jenkins, KY
- NPI 1790743607
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.