NPIMap

Individual provider Active NPI

Paul Roger Cordts, M.D.

  • Surgery Physician
  • Fort Campbell, KY
National Provider Identifier
1801875042
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
87-35 Issued in NM
Practice address
1599 Choctaw Loop
Fort Campbell, KY 42223-1043
Phone
(270) 798-8041
Fax
(270) 798-8838
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 87-35 NM Primary
Surgical Critical Care Physician 2086S0102X 87-35 NM
Vascular Surgery Physician 2086S0129X 87-35 NM

Addresses

Primary practice location

1599 Choctaw Loop
Fort Campbell, KY 42223-1043

Mailing address

1599 Choctaw Loop
Fort Campbell, KY 42223-1043
Phone (270) 798-8041

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87-35NMMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1801875042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 CHOCTAW LOOP",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422231043",
            "telephone_number": "270-798-8041",
            "fax_number": "270-798-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 CHOCTAW LOOP",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422231043",
            "telephone_number": "270-798-8041",
            "fax_number": "270-798-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDTS",
        "first_name": "PAUL",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "87-35",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NM",
            "license": "87-35",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "87-35",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.