NPIMap

Organization Active NPI

Fivco Add Cdo As Fiscal Agent

  • Supports Brokerage Agency
  • Ashland, KY
National Provider Identifier
1801097993
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
Legal business name
FIVCO ADD CDO AS FISCAL AGENT
Practice address
1212 Bath Ave
Suite 650
Ashland, KY 41101-2696
Phone
(606) 929-1366
Fax
(606) 327-0023
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sherry McDavid
Title
Executive Director
Phone
(606) 929-1366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X Primary

Addresses

Primary practice location

1212 Bath Ave
Suite 650
Ashland, KY 41101-2696

Mailing address

1212 Bath Ave
Suite 650
Ashland, KY 41101-2696
Phone (606) 929-1366

Other identifiers 3

IdentifierTypeStateIssuer
43996107MedicaidKY
33001447MedicaidKY
17000811MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Fivco Add Cdo As Fiscal Agent3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801097993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 BATH AVE",
            "address_2": "SUITE 650",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012696",
            "telephone_number": "606-929-1366",
            "fax_number": "606-327-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BATH AVE",
            "address_2": "SUITE 650",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012696",
            "telephone_number": "606-929-1366",
            "fax_number": "606-327-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVCO ADD CDO AS FISCAL AGENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDAVID",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "606-929-1366"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43996107",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33001447",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17000811",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • 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.