Individual provider Active NPI

Ashraf Azeb, MD

  • Emergency Medicine Physician
  • Manchester, KY
National Provider Identifier
1902852049
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34208 Issued in KY
Practice address
210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone
(606) 598-5104
Fax
(865) 291-3228
NPI assigned
May 26, 2006
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34208 KY Primary

Addresses

Primary practice location

210 Marie Langdon Dr
Manchester, KY 40962-6388

Mailing address

111 Blair St
Pikeville, KY 41501-1643

Other identifiers 2

IdentifierTypeStateIssuer
64093677MedicaidKY
64342082MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310002014 KY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3678513173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34208KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Our Lady of the Way Hospital, Inc Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Southern Medical Partners, LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1902852049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BLAIR ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MARIE LANGDON DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626388",
            "telephone_number": "606-598-5104",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEB",
        "first_name": "ASHRAF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "34208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64093677",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64342082",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.