Organization Active NPI

Tri-State Digestive Disease Assoc PSC.

  • Gastroenterology Physician
  • Ashland, KY
National Provider Identifier
1851467237
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
TRI-STATE DIGESTIVE DISEASE ASSOC PSC.
Practice address
617 23Rd St
Suiye 11
Ashland, KY 41101-2845
Phone
(606) 324-3188
Fax
(606) 329-2237
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Dr. Michael Don Canty, M.D.
Title
President
Phone
(606) 324-3188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X KY Primary

Addresses

Primary practice location

617 23Rd St
Suiye 11
Ashland, KY 41101-2845

Mailing address

617 23Rd St
Suite 11
Ashland, KY 41101-2880
Phone (606) 324-3188

Other identifiers 2

IdentifierTypeStateIssuer
0126072MedicaidOH
65920845MedicaidKY

National Provider Directory

National Provider Directory

Locations

617 23rd St
Ste 11
Ashland, KY 41101
Phone (606) 324-3188

617 23rd St
Ashland, KY 41101
Phone (606) 326-0300

Practitioners & affiliated clinicians

Practitioners 2

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1851467237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 23RD ST",
            "address_2": "SUITE 11",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012880",
            "telephone_number": "606-324-3188",
            "fax_number": "606-329-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST",
            "address_2": "SUIYE 11",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012845",
            "telephone_number": "606-324-3188",
            "fax_number": "606-329-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE DIGESTIVE DISEASE ASSOC PSC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "CANTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-324-3188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126072",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65920845",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.