EASTERN KENTUCKY UNIVERSITY (NPI# 1164460051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164460051 |
| Entity Type | Organization |
| Organization Name | EASTERN KENTUCKY UNIVERSITY |
| Other Organization Name | BLUEGRASS COMMUNITY HEALTH CENTER |
| Practice Address |
1306 Versailles Rd Suite 120 Lexington KY 40504-1117 |
| Practice Telephone | 8592590717 |
| Practice Fax Number | 8592547874 |
| Mailing Telephone | 8592590717 |
| Mailing Fax Number | 8592547874 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2013-08-30 |
| Authorized Official Name | DR. SUSAN G. FISTER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8592590717 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
700160 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 31001118 | 05 | |
| KY | ANTHEM | 000000537566 | 01 |
| KY | AETNA | 9968164 | 01 |
| Other Name | Type Code |
|---|---|
| Bluegrass Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831386192 | Eastern Kentucky University | Clinic/Center | 151 N Eagle Creek, Suite 220, Lexington, KY 40509-1892 | 2007-10-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EASTERN KENTUCKY UNIVERSITY | 521 Lancaster Ave, Richmond, KY 40475-3102 |
| Street Address |
1306 VERSAILLES RD SUITE 120 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40504-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467893081 | Julie Ann Clarke | Social Worker | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2013-07-11 |
| 1437450269 | Elizabeth Frances Epperson | Social Worker | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2010-11-10 |
| 1457582017 | Iris E Draughn | Nurse Practitioner | 1306 Versailles Rd, Suite 120, Lexington, KY 40504-1796 | 2009-07-30 |
| 1831329945 | Lisa J Hernandez | Social Worker | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2009-07-23 |
| 1891931523 | Andrea Ellen Zimmermann | Nurse Practitioner | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2008-12-30 |
| 1689795536 | Lora Mutiso | Nurse Practitioner | 1306 Versailles Rd, Suite 120, Lexington, KY 40504-1796 | 2007-04-02 |
| 1336295369 | Christopher G Westerman | Counselor | 1306 Versailles Rd, Lexington, KY 40504-1796 | 2007-01-25 |
| 1518973064 | Joyce Ann Allen | Nurse Practitioner | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2006-08-01 |
| 1659393700 | Stanley W Sizemore | Family Medicine | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2006-07-24 |
| 1922048503 | Alan Stevens Wrightson Jr. | Family Medicine | 1306 Versailles Rd, Ste 120, Lexington, KY 40504-1796 | 2006-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740809953 | Michael Jason Blocker | Registered Nurse | 1 St Hoseph Drive, Lexington, KY 40504 | 2020-04-09 |
| 1841842010 | Jessica Brooke Castleberry | Counselor | Chrysalis House, Inc., 1589 Hill Rise Drive, Lexington, KY 40504 | 2019-07-09 |
| 1528554474 | Hillcrest Pain & Spine Pllc | Pain Medicine | 853 Lane Allen Rd Ste 217, Lexington, KY 40504 | 2018-07-03 |
| 1366962474 | Jessica Hope King | Dentist | 1330 Harrodsburg Road, Lexington, KY 40504 | 2017-06-21 |
| 1255861076 | Mary Elizabeth Bailey | Dentist | 1330 Harrodsburg Rd, Lexington, KY 40504 | 2017-06-14 |
| 1295172211 | Alan Kidon | Podiatrist | 1401 Harrodsburg Rd Ste C115, Lexington, KY 40504 | 2013-05-31 |
| 1578847554 | Linda W Mcdaniel | Pharmacist | 2181 Harrodsburg Road, Lexington, KY 40504 | 2011-10-07 |
| 1578844197 | Amber Kincaid Ballard | Nurse Practitioner | Uk Healthcare Team Blue Primary Care Clinic, 2400 Great Stone Point, Lexington, KY 40504 | 2011-09-09 |
| 1104118124 | Harry W Tenfelde IIi | Pharmacist | 2284 Versailles Rd., Lexington, KY 40504 | 2011-05-10 |
| 1831495506 | Horizon Headache Center, Pllc | Physical Therapist | 2365 Harrodsburg Road, Suite B-100, Lexington, KY 40504 | 2011-01-28 |
| Find all providers in zip 40504 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295356731 | Health Care Coalition of Lafayette County | Clinic/Center | 811 S Business Highway 13, Lexington, MO 64067-1515 | 2020-05-06 |
| 1104348606 | Mallory Community Health | Clinic/Center | 9479 Brozville Rd, Lexington, MS 39095-7090 | 2017-07-17 |
| 1295282358 | Mallory Community Health | Clinic/Center | 9749 Brozville Road, Lexington, MS 39095 | 2016-09-07 |
| 1427504943 | Mallory Community Health | Clinic/Center | 12572 Highway 12, Lexington, MS 39095-8036 | 2016-08-26 |
| 1982002549 | Samuel U. Rodgers Health Center, Inc | Clinic/Center | 2309 Aull Ln, Lexington, MO 64067 | 2014-12-15 |
| 1740624881 | Mallory Community Health | Clinic/Center | 300 Yazoo Street, Lexington, MS 39095 | 2013-04-19 |
| 1831386192 | Eastern Kentucky University | Clinic/Center | 151 N Eagle Creek, Suite 220, Lexington, KY 40509-1892 | 2007-10-01 |
| 1164614053 | Samuel U. Rodgers Health Center, Inc. | Clinic/Center | 811 S Business Highway 13 Ste A, Lexington, MO 64067 | 2007-08-14 |
| 1053951756 | Gaston Family Health Services, Inc | Clinic/Center | 32 Kirkwood Ave, Lexington, NC 27292-4024 | 2020-01-10 |
| 1992343206 | Healthfirst Bluegrass Inc. | Clinic/Center | 350 N Limestone, Lexington, KY 40508-1871 | 2019-12-17 |
| Find all providers in LEXINGTON | ||||
Please comment or provide details below to improve the information on EASTERN KENTUCKY UNIVERSITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.