NPIMap

Organization Active NPI

Cecil Clinic, PLLC

  • Developmental - Behavioral Pediatrics Physician
  • Paducah, KY
National Provider Identifier
1831448679
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
CECIL CLINIC, PLLC
Practice address
2670 New Holt Rd Ste C
Paducah, KY 42001-7506
Phone
(270) 575-1010
Fax
(270) 575-1018
NPI assigned
Sep 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
Dr. John T Cecil Jr., MD
Title
Sole Member
Phone
(270) 575-1010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA403 KY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2670 New Holt Rd Ste C
Paducah, KY 42001-7506

Mailing address

PO Box 14252
Belfast, ME 04915-4035
Phone (270) 575-1010

Other identifiers 2

IdentifierTypeStateIssuer
7100217100MedicaidKY
7100217070MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1831448679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14252",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154035",
            "telephone_number": "270-575-1010",
            "fax_number": "270-575-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 NEW HOLT RD STE C",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017506",
            "telephone_number": "270-575-1010",
            "fax_number": "270-575-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CECIL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "CECIL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "270-575-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA403",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100217100",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100217070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.