NPIMap

Organization Active NPI

Caldwell County Medical Clinic

  • Nephrology Physician
  • Princeton, KY
National Provider Identifier
1801905906
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CALDWELL COUNTY MEDICAL CLINIC
Practice address
323 S Jefferson St
Suite D
Princeton, KY 42445-2100
Phone
(270) 365-4505
Fax
(270) 365-4539
NPI assigned
Aug 30, 2006
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Dana Evans
Title
Provider Enrollment Rep
Phone
(270) 744-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

323 S Jefferson St
Suite D
Princeton, KY 42445-2100

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1801905906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S JEFFERSON ST",
            "address_2": "SUITE D",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424452100",
            "telephone_number": "270-365-4505",
            "fax_number": "270-365-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL COUNTY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT REP",
        "authorized_official_telephone_number": "270-744-9600"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.