Bellefonte Physician Services, Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

BELLEFONTE PHYSICIAN SERVICES, INC.

Practice address

2222 Winchester Ave
Ste. C
Ashland, KY 41101

Phone

(606) 325-8634

NPI assigned

Sep 10, 2013

Organization subpart

No

Name

Mr. Troy Connett

Title

Director of Finance

Phone

(606) 833-3333

• Tri-State Neuro Solutions Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 13, 2018.

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1922433978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2155",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052155",
            "telephone_number": "877-214-4267",
            "fax_number": "606-833-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WINCHESTER AVE",
            "address_2": "STE. C",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-325-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEFONTE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "CONNETT",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "606-833-3333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095545",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100283780",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-State Neuro Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tri-State Neuro Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• Bellefonte Physician Services, Inc.
• David E Bellville, PA
• Ben J. O'Dell, MD, PSC
• Jamie Bennett
• Kayla Ambria Bennett, PTA

• All providers in Ashland, KY
• Neurology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.