Active NPI
Jamie Fannin, MS, ACSM-CEP
- Clinical Exercise Physiologist
- Lexington, KY
National Provider Identifier
1790435543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- Practice address
- 135 E Maxwell St Ste 103
Lexington, KY 40508-2621 - Phone
- (859) 323-5424
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | KY | Primary |
Addresses
Primary practice location
135 E Maxwell St Ste 103
Lexington, KY 40508-2621
Mailing address
135 E Maxwell St Ste 103
Lexington, KY 40508-2621
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 429776 | Medicaid | KY | |
| 1065850 | Medicaid | KY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jamie.fannin@uky.edu | Direct | University of Kentucky |
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Kentucky | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Lexington, KY
- NPI 1770771974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648166400000",
"number": "1790435543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 E MAXWELL ST STE 103",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405082621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 E MAXWELL ST STE 103",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405082621",
"telephone_number": "859-323-5424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "JAMIE",
"credential": "MS, ACSM-CEP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-25",
"last_updated": "2022-03-25",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "429776",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1065850",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jamie.fannin@uky.edu",
"affiliation": "Y",
"endpointDescription": "email",
"affiliationName": "University of Kentucky",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "800 Rose St",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405360001",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.