NPIMap

Individual provider Active NPI

Christopher D Dobrose, M.D.

  • Family Medicine Physician
  • Mayfield, KY
National Provider Identifier
1871564666
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39595 Issued in KY
Practice address
1111 Medical Center Cir
Mayfield, KY 42066-1194
Phone
(270) 251-4055
Fax
(270) 251-4059
NPI assigned
Jan 30, 2006
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39595 KY Primary

Addresses

Primary practice location

1111 Medical Center Cir
Mayfield, KY 42066-1194

Mailing address

1111 Medical Center Cir
Mayfield, KY 42066-1194
Phone (270) 251-4055

Other identifiers 1

IdentifierTypeStateIssuer
64111693MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050825000236 KY Practitioner - Family Practice 8325079783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinelake Physician Practice LLCGroup PAC ID 6800797507, 45 clinicians

Practice addresses (Care Compare)

1111 Medical Ctr Cir
Mayfield, KY 42066-1194
Phone (270) 251-4055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39595KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinelake Physician Practice, LLC Family Medicine Current Accepting new patients
Pinelake Physician Practice, LLC CurrentSince Aug 1, 2011 Accepting new patients
Pinelake Physician Practice, LLC Family Medicine CurrentSince Aug 1, 2011 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Healthstar Physicians, P.C. Family Medicine Past Accepting new patients
Oncology Hematology Consultants, PSC Past Accepting new patients
Morgan-Haugh Professional Services Corporation Family Medicine Past Accepting new patients
Jefferson Family Physicians P C Family Medicine Past Accepting new patients

Locations

1029 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1029 Medical Center Cir
Ste 401
Mayfield, KY 42066
Phone (270) 251-4590

1111 Medical Center Cir
Mayfield, KY 42066
Phone (270) 247-8100

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: christopher.dobrose.1@19475.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1871564666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-251-4055",
            "fax_number": "270-251-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-251-4055",
            "fax_number": "270-251-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBROSE",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "39595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64111693",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield, KY

Sources for this page

Verify at the official NPI Registry.