Individual provider Active NPI

Maxine Bobys, P.A.

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1780689273
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA299 Issued in KY
Practice address
1775 Alysheba Way
Ste 201
Lexington, KY 40509-2279
Phone
(859) 278-5007
Fax
(859) 278-6867
NPI assigned
Jun 20, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA299 KY Primary

Addresses

Primary practice location

1775 Alysheba Way
Ste 201
Lexington, KY 40509-2279

Mailing address

1775 Alysheba Way
Ste 201
Lexington, KY 40509-2279
Phone (859) 278-5007

Other identifiers 1

IdentifierTypeStateIssuer
9500393500MedicaidKY

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA299KYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780689273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 ALYSHEBA WAY",
            "address_2": "STE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092279",
            "telephone_number": "859-278-5007",
            "fax_number": "859-278-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 ALYSHEBA WAY",
            "address_2": "STE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092279",
            "telephone_number": "859-278-5007",
            "fax_number": "859-278-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBYS",
        "first_name": "MAXINE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500393500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.