NPIMap

Organization Active NPI

C Fred Gott M.D.

  • Multi-Specialty Clinic/Center
  • Bowling Green, KY
National Provider Identifier
1760547103
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
20987 Issued in KY
Legal business name
C FRED GOTT M.D.
Practice address
191 W Professional Park CT
Bowling Green, KY 42104-3230
Phone
(270) 782-7464
Fax
(270) 782-8025
NPI assigned
Dec 26, 2006
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Robert Bedard
Title
Practice Manager
Phone
(270) 782-7464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 20987 KY Primary

Addresses

Primary practice location

191 W Professional Park CT
Bowling Green, KY 42104-3230

Mailing address

PO Box 1078
Bowling Green, KY 42102-1078
Phone (270) 782-7464

National Provider Directory

National Provider Directory

Locations

191 W Professional Park Ct
Bowling Green, KY 42104
Phone (270) 782-7464

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1760547103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421021078",
            "telephone_number": "270-782-7464",
            "fax_number": "270-782-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 W PROFESSIONAL PARK CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043230",
            "telephone_number": "270-782-7464",
            "fax_number": "270-782-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C FRED GOTT M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "BEDARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "270-782-7464"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KY",
            "license": "20987",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 13, 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.

Verify at the official NPI Registry.