Organization Active NPI

Somerset Pediatric Specialists PLLC

  • Pediatrics Physician
  • Somerset, KY
National Provider Identifier
1902031602
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOMERSET PEDIATRIC SPECIALISTS PLLC
Practice address
350 Langdon St
Somerset, KY 42503-2786
Phone
(606) 678-8155
NPI assigned
May 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Authorized official

Name
Janie Ison
Title
Asst. Office Manager
Phone
(606) 678-8155

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

350 Langdon St
Somerset, KY 42503-2786

Mailing address

350 Langdon St
Somerset, KY 42503-2786
Phone (606) 678-8155

Other identifiers 2

IdentifierTypeStateIssuer
7100087290 - MDMedicaidKY
7100087330 - NPMedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1902031602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032786",
            "telephone_number": "606-678-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032786",
            "telephone_number": "606-678-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET PEDIATRIC SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "ISON",
        "authorized_official_first_name": "JANIE",
        "authorized_official_title_or_position": "ASST. OFFICE MANAGER",
        "authorized_official_telephone_number": "606-678-8155"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100087290 - MD",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100087330 - NP",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.