Northeastern Kentucky Surgeons, PSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NORTHEASTERN KENTUCKY SURGEONS, PSC

Practice address

617 23Rd St
Suite 13
Ashland, KY 41101-2845

Phone

(606) 325-1151

Fax

(606) 324-4168

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

David Legenza

Title

Business Manager

Phone

(606) 325-1151

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770568578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 23RD ST",
            "address_2": "SUITE 13",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012845",
            "telephone_number": "606-325-1151",
            "fax_number": "606-324-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST",
            "address_2": "SUITE 13",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012845",
            "telephone_number": "606-325-1151",
            "fax_number": "606-324-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN KENTUCKY SURGEONS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEGENZA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "606-325-1151"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65936429",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "31L2",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey K Nicholson
• Harley Nolan
• Penny Nolen
• Cassandra Rachel Norris, B.A., M.S.
• Northeast Kentucky Imaging Inc
• Ben J O'Dell, M.D.
• Bryan O'Dell, CRNA
• Maurice J Oakley, M.D.
• Oakview Elementary School-Ais
• Obhg Kentucky, P.S.C.

• Surgery Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.