NPIMap

Organization Active NPI

Douglas E. Vick, DO M. Tamarin Vick, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Versailles, KY
National Provider Identifier
1982875050
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
02382 Issued in KY
Legal business name
DOUGLAS E. VICK, DO M. TAMARIN VICK, DO
Practice address
208 Crossfield Dr
Versailles, KY 40383-1468
Phone
(859) 873-8044
Fax
(859) 873-8045
NPI assigned
Mar 17, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Mary Tamarin Vick, D.O.NPI 1659596112
Title
Practitioner
Phone
(859) 873-8044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 02382 KY Primary
Family Medicine Physician 207Q00000X 02382 KY
General Practice Physician 208D00000X 02383 KY

Addresses

Primary practice location

208 Crossfield Dr
Versailles, KY 40383-1468

Mailing address

208 Crossfield Dr
Versailles, KY 40383-1468
Phone (859) 873-8044

National Provider Directory

National Provider Directory

Locations

208 Crossfield Dr
Versailles, KY 40383
Phone (859) 873-4508

Practitioners & affiliated clinicians

Practitioners 3

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": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1982875050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831468",
            "telephone_number": "859-873-8044",
            "fax_number": "859-873-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831468",
            "telephone_number": "859-873-8044",
            "fax_number": "859-873-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS E. VICK, DO M. TAMARIN VICK, DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "TAMARIN",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "859-873-8044",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "KY",
            "license": "02382",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02382",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "02383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.