Central Kentucky Radiology

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CENTRAL KENTUCKY RADIOLOGY

Practice address

124 Daniel Dr
Danville, KY 40422-2527

Phone

(859) 936-9974

Fax

(859) 936-0973

NPI assigned

Apr 13, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jon K Kostelic, MDNPI 1700842275

Title

President

Phone

(859) 219-0542

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Danville Diagnostic Center Other name

Practitioners 1

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

• Jon K Kostelic, M.D.

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1700842275
  NPD Authorized official

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1902049513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 S BROADWAY",
            "address_2": "STE 310",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042759",
            "telephone_number": "859-219-0542",
            "fax_number": "859-219-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 DANIEL DR",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222527",
            "telephone_number": "859-936-9974",
            "fax_number": "859-936-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "KOSTELIC",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-219-0542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000061387",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65931644",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Danville Diagnostic Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Kentucky Kidney Care LLC
• Central Kentucky Kidney Center LLC
• Central Kentucky Plastic Surgery, PLLC
• Central Kentucky Psychiatry, PLLC
• Central Kentucky Radiation Oncology Group
• Central Kentucky Spine Surgery, PLLC
• Central Kentucky Surgeons, PSC
• Robin T. Cerridwen, CRNA
• Charles J Zimmermann DPM
• Rebecca P Chatham, MD

• Diagnostic Radiology Physician in Danville, KY
• Providers in Danville, KY by specialty
• Diagnostic Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.