Jackson Purchase Pulmonary Medicine PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

40940 Issued in KY

Legal business name

JACKSON PURCHASE PULMONARY MEDICINE PLLC

Practice address

1111 Medical Center Cir
Mayfield, KY 42066-1194

Phone

(270) 650-7163

Fax

(855) 430-0335

NPI assigned

Jul 16, 2008

Last updated

Jun 23, 2020By 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

Dr. Roberto Dos Remedios, M.D.NPI 1497872899

Title

Owner

Phone

(270) 933-7823

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Tax ID family

Jackson Purchase Pulmonary Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jackson Purchase Pulmonary Medicine PLLC

  • Family Nurse Practitioner
  • Mayfield, KY
  • NPI 1992254288
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFGGAA

Practitioners 2

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.

• Roberto Dos Remedios, MD

  • Pulmonary Disease Physician
  • Mayfield, KY
  • NPI 1497872899
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer L Carrico, APRN

  • Family Nurse Practitioner
  • Mayfield, KY
  • NPI 1114383981
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1922262179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-251-4040",
            "fax_number": "855-430-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-650-7163",
            "fax_number": "855-430-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PURCHASE PULMONARY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "DOS REMEDIOS",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-933-7823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010022",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "40940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D Irvin, M.D.
• Myra Irvin, MD
• J.U. Kevil Memorial Foundation, Inc.
• Jackson Purchase Cardiology
• Jackson Purchase Pediatrics, PLLC
• Jackson Purchase Pulmonary Medicine PLLC
• James H Adams Jr PSC
• Hailey Elisabeth Jarvis, PHARMD
• Michelle Ann Jewell, APRN
• Marquetta L Johnson, LPCC

• Pulmonary Disease Physician in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Pulmonary Disease Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.