C. Craig Stafford, MD PSC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

24728 Issued in KY

Legal business name

C. CRAIG STAFFORD, MD PSC

Practice address

1401 Harrodsburg Road
A-450
Lexington, KY 40504-3794

Phone

(859) 373-0215

Fax

(859) 373-0235

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Charles Craig Stafford, MD

Title

Owner/MD

Phone

(859) 373-0215

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1831408046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "address_2": "BLDG A STE 450",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-373-0215",
            "fax_number": "859-373-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG ROAD",
            "address_2": "A-450",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043794",
            "telephone_number": "859-373-0215",
            "fax_number": "859-373-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. CRAIG STAFFORD, MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "859-373-0215",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "24728",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100143740",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100144720",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Nephrology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.