Active NPI
Nicholas Roger Jurich, M.D.
- Family Medicine Physician
- Prestonsburg, KY
National Provider Identifier
1952393282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 15888
- Practice address
- 1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889 - Phone
- (606) 886-1760
- Fax
- (606) 886-3590
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15888 | KY | Primary |
Addresses
Primary practice location
1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Mailing address
PO Box 1595
Ashland, KY 41105-1595
Phone (606) 408-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64158884 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15888 | KY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1952393282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1595",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411051595",
"telephone_number": "606-408-6200",
"fax_number": "606-408-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1279 OLD ABBOTT MOUNTAIN RD",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416531889",
"telephone_number": "606-886-1760",
"fax_number": "606-886-3590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURICH",
"first_name": "NICHOLAS",
"middle_name": "ROGER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "15888",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64158884",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prestonsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.