NPIMap

Organization Active NPI

Lexington Infectious Disease Consultants PSC

  • Infectious Disease Physician
  • Lexington, KY
National Provider Identifier
1922158294
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
LEXINGTON INFECTIOUS DISEASE CONSULTANTS PSC
Practice address
1720 Nicholasville Rd
Ste 602
Lexington, KY 40503-1404
Phone
(859) 277-4005
Fax
(859) 278-2507
NPI assigned
Jan 11, 2007
Last updated
Jun 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Authorized official

Name
Dr. Mark J DoughertyNPI 1326049628
Title
President
Phone
(859) 277-4005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Critical Care Medicine Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC0200X

Addresses

Primary practice location

1720 Nicholasville Rd
Ste 602
Lexington, KY 40503-1404

Mailing address

1720 Nicholasville Rd
Ste 602
Lexington, KY 40503-1404
Phone (859) 277-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526000423 KY Part B Supplier - Clinic/Group Practice 5193706174 Receives reassigned benefits from 16 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

1720 Nicholasville Rd
Ste 602
Lexington, KY 40503
Phone (859) 277-4005

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1922158294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD",
            "address_2": "STE 602",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031404",
            "telephone_number": "859-277-4005",
            "fax_number": "859-278-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD",
            "address_2": "STE 602",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031404",
            "telephone_number": "859-277-4005",
            "fax_number": "859-278-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON INFECTIOUS DISEASE CONSULTANTS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-277-4005",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.