Colorectal Care of Northern Ky, PLLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

COLORECTAL CARE OF NORTHERN KY, PLLC

Practice address

2865 Chancellor Dr
Ste 215
Crestview Hills, KY 41017-3912

Phone

(859) 341-9659

Fax

(859) 341-9659

NPI assigned

May 24, 2005

Last updated

Aug 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dean R Adams, MD

Title

President

Phone

(859) 341-9659

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1922001833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "BURLINGTON",
            "state": "KY",
            "postal_code": "410050272",
            "telephone_number": "513-891-2813",
            "fax_number": "513-891-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 CHANCELLOR DR",
            "address_2": "STE 215",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173912",
            "telephone_number": "859-341-9659",
            "fax_number": "859-341-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORECTAL CARE OF NORTHERN KY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-341-9659",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD6452",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2948949",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200927190A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Colon & Rectal Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.