Paducah Plastic and Reconstructive Surgery

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

PADUCAH PLASTIC AND RECONSTRUCTIVE SURGERY

Practice address

2605 Kentucky Ave Ste 100
Paducah, KY 42003-3800

Phone

(270) 709-1984

Fax

(270) 933-1047

NPI assigned

Jun 14, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Daniel E Verbist, MDNPI 1497194567

Title

Member/Manager

Phone

(270) 709-1984

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel E Verbist, MD

  • Plastic and Reconstructive Surgery Physician
  • Paducah, KY
  • NPI 1497194567
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1962070334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE STE 100",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-709-1984",
            "fax_number": "270-933-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE STE 100",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-709-1984",
            "fax_number": "270-933-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PADUCAH PLASTIC AND RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "VERBIST",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "270-709-1984",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paducah Operating Company LLC
• Paducah Ophthalmology ASC LLC
• Paducah Pediatric Dentistry PSC
• Paducah Physiatric Partners P.S.C.
• Paducah Physical Therapy and Pschology Center, PSC
• Paducah Primary Care, P.S.C.
• Paducah Psychiatry Group PSC
• Paducah Public Schools
• Paducah Recovery LLC
• Paducah Surgical Associates, PLLC

• Plastic and Reconstructive Surgery Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Plastic and Reconstructive Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.