Organization Active NPI

Commonwealth Specialists of Kentucky, LLC

  • Surgery Physician
  • Frankfort, KY
National Provider Identifier
1972770170
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
COMMONWEALTH SPECIALISTS OF KENTUCKY, LLC
Practice address
299 Kings Daughters Dr
Frankfort, KY 40601-6514
Phone
(502) 226-7530
Fax
(502) 226-7936
NPI assigned
May 15, 2008
Last updated
Sep 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
William T. Johnson
Title
VP
Phone
(804) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

299 Kings Daughters Dr
Frankfort, KY 40601-6514

Mailing address

299 Kings Daughters Dr
Suite 108
Frankfort, KY 40601-6514
Phone (502) 226-7930

Other identifiers 3

IdentifierTypeStateIssuer
609106OtherKYANTHEM
64136732MedicaidKY
P00724142OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

299 Kings Daughters Dr
Ste 108
Frankfort, KY 40601

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1972770170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 KINGS DAUGHTERS DR",
            "address_2": "SUITE 108",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406016514",
            "telephone_number": "502-226-7930",
            "fax_number": "502-226-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 KINGS DAUGHTERS DR",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406016514",
            "telephone_number": "502-226-7530",
            "fax_number": "502-226-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH SPECIALISTS OF KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "804-237-7760"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "609106",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64136732",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00724142",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.