Winit Chartisathian, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

21307 Issued in KY

Practice address

73 Kingswood Dr
Campbellsville, KY 42718-9604

Phone

(270) 789-1112

Fax

(270) 789-3157

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811062151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189604",
            "telephone_number": "270-789-1112",
            "fax_number": "270-789-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189604",
            "telephone_number": "270-789-1112",
            "fax_number": "270-789-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARTISATHIAN",
        "first_name": "WINIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "21307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6421307700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Kentucky Surgical Institute
• Central Kentucky Surgical Institute, PSC
• Central Kentucky Surgical Services LLC
• Central Ky Hearing Care, Inc
• Century Pharmacy Inc (Century Medicines)
• Christian Care Communities, Inc. (Pathways of Central Kentucky)
• City of Campbellsville Ky (Campbellsville Taylor County EMS)
• Sara Clemmons
• Brandy Close
• CNRF LLC (The Grandview)

• Pediatric Adolescent Medicine Physician in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Pediatric Adolescent Medicine Physician in Kentucky

• 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.