South Oldham Medical Clinic PSC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

30373 Issued in KY

Legal business name

SOUTH OLDHAM MEDICAL CLINIC PSC

Practice address

6520 W Hwy 22
Crestwood, KY 40014

Phone

(502) 241-8488

Fax

(502) 241-7424

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Ashor Alur, MD

Title

Physician Owner

Phone

(502) 241-8488

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922142983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 W HWY 22",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "40014",
            "telephone_number": "502-241-8488",
            "fax_number": "502-241-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 W HWY 22",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "40014",
            "telephone_number": "502-241-8488",
            "fax_number": "502-241-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH OLDHAM MEDICAL CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALUR",
        "authorized_official_first_name": "ASHOR",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "502-241-8488",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "KY",
            "license": "30373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64303738",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SN Kentuckiana Rehab, LLC
• SN Kentuckiana Rehab, LLC
• Karin L Soltau, LCSW
• Hina Soni, PHARM D
• South Oldham Family Care
• Haley Deniese Spalding, BCBA
• Andrew Steele, O.D.
• Jennifer Stocker
• Misty M Stutz, PHARMD
• Ashley Sumner, R.D.

• General Practice Physician in Crestwood, KY
• Providers in Crestwood, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.