NPIMap

Organization Active NPI

Bluegrass Renal Care, PSC

Doing business as Bluegrass Medical Alliance

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1831936343
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLUEGRASS RENAL CARE, PSC
Doing business as
Bluegrass Medical Alliance
Practice address
3229 Summit Square PL Ste 240
Lexington, KY 40509-2664
Phone
(859) 263-1717
NPI assigned
Jul 11, 2024
Last updated
Jul 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Ziad W. Deeb SaraNPI 1093753063
Title
MD / Owner
Phone
(859) 263-1717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3229 Summit Square PL Ste 240
Lexington, KY 40509-2664

Mailing address

PO Box 896
Winchester, KY 40392-0896

Other names 1

  • Bluegrass Medical Alliance Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1831936343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403920896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 SUMMIT SQUARE PL STE 240",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092664",
            "telephone_number": "859-263-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS RENAL CARE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "DEEB SARA",
        "authorized_official_first_name": "ZIAD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MD / OWNER",
        "authorized_official_telephone_number": "859-263-1717"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluegrass Medical Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.