Pamela K Harston, MD, PLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

KY25936 Issued in KY

Legal business name

PAMELA K HARSTON, MD, PLC

Practice address

1890 Lyda Ave
Suite 103
Bowling Green, KY 42104-5829

Phone

(270) 904-6160

Fax

(270) 904-6165

NPI assigned

Oct 13, 2009

Organization subpart

No

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

Authorized official

Name

Pamela Kaye Harston, MD

Title

Business Owner

Phone

(270) 904-6160

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1760717516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LYDA AVE",
            "address_2": "SUITE 103",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045829",
            "telephone_number": "270-904-6160",
            "fax_number": "270-904-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LYDA AVE",
            "address_2": "SUITE 103",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045829",
            "telephone_number": "270-904-6160",
            "fax_number": "270-904-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA K HARSTON, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "HARSTON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "270-904-6160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KY",
            "license": "KY25936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64259369",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.