Active NPI
Ashraf Azeb, MD
- Emergency Medicine Physician
- Manchester, KY
National Provider Identifier
1902852049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 34208
- 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, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64093677 | Medicaid | KY | |
| 64342082 | Medicaid | KY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160310002014 | KY | Order and Referring Only - Internal Medicine | 3678513173 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34208 | KY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Family Medicine Physician
- Martin, KY
- NPI 1255357364
-
- Emergency Medicine Physician
- Hazard, KY
- NPI 1538109962
-
- Nurse Practitioner
- Lawrenceburg, TN
- NPI 1053351593
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.