CENTRAL KENTUCKY RADIOLOGY (NPI# 1902049513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902049513 |
| Entity Type | Organization |
| Organization Name | CENTRAL KENTUCKY RADIOLOGY |
| Other Organization Name | DANVILLE DIAGNOSTIC CENTER |
| Practice Address |
124 Daniel Dr Danville KY 40422-2527 |
| Mailing Address |
1218 S Broadway Ste 310 Lexington KY 40504-2759 |
| Practice Telephone | 8599369974 |
| Practice Fax Number | 8599360973 |
| Mailing Telephone | 8592190542 |
| Mailing Fax Number | 8592199433 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |
| Authorized Official Name | DR. JON K KOSTELIC (PRESIDENT) |
| Authorized Official Telephone | 8592190542 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM | 000000061387 | 01 |
| KY | 65931644 | 05 |
| Other Name | Type Code |
|---|---|
| Danville Diagnostic Center | Other Name - Individual/Organization |
| Street Address |
124 DANIEL DR |
| City | DANVILLE |
| State | KY |
| Zip Code | 40422-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053631804 | Pallaki D Ravi | Family Medicine | 124 Daniel Dr, Danville, KY 40422 | 2010-06-03 |
| 1558696989 | Vidhya Lakshmi Ravi | Family Medicine | 124 Daniel Dr, Danville, KY 40422 | 2009-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568098754 | Healthstat Onsite Clinic Centre College | Preventive Medicine | 851 West Walnut St, Danville, KY 40422 | 2020-03-19 |
| 1134772288 | Austin Simpson | Physician Assistant | 217 South 3rd Street, Danville, KY 40422 | 2019-07-18 |
| 1033677695 | Shannon Holland Erwin | Counselor | 475 W Main St Suite 160, Danville, KY 40422 | 2019-03-03 |
| 1225556871 | Fallon Michelle Carnes | Counselor | 106 Belinda Blvd., Danville, KY 40422 | 2017-09-05 |
| 1780124529 | Natasha Taylor | Counselor | 461 South 4th Street, Danville, KY 40422 | 2017-02-27 |
| 1184088890 | Elizabeth Love | Counselor | 108 Saint Josephs Ct, Danville, KY 40422 | 2016-04-08 |
| 1801274550 | Jeremy Tate Johnson | Specialist/Technologist | 1637 Perryville Rd., Boyle County High School, Danville, KY 40422 | 2015-05-14 |
| 1649602228 | Susan Hale Couzens | Dentist | 435 Whirlaway Dr, Danville, KY 40422 | 2013-08-06 |
| 1265751200 | William Paul Baas | Ophthalmology | 440 W. Martin L. King Blvd., Suite 100, Danville, KY 40422 | 2010-05-28 |
| 1780823666 | Karen Totsuka IIi | Speech-Language Pathologist | 642 Nth 3rd St, Danville, KY 40422 | 2009-02-17 |
| Find all providers in zip 40422 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114245990 | John Cho | Radiology | 105 Ridgeview, Danville, PA 17821-8435 | 2010-05-04 |
| 1831119254 | Richard Keith Hollis | Radiology | 692 Rocky Knoll Ln, Danville, VA 24541-8932 | 2006-07-20 |
| 1255356820 | United Radiology Service | Radiology | 812 North Logan Avenue, Danville, IL 61832 | 2006-07-13 |
| 1548226186 | Laurence John Soges | Radiology | Geisinger Medical Center, Dept Radiology, 100 N Academy Ave, Danville, PA 17822-0001 | 2006-04-22 |
| 1528038692 | Henry Huson II | Radiology | 288 W Main St, Danville, VA 24541-2848 | 2006-01-23 |
| 1538149448 | Douglas R May | Radiology | 142 S Main St, Danville, VA 24541-2922 | 2006-01-18 |
| 1205446390 | Dm Radiology LLC | Radiology | 304 Virginia Ave, Danville, VA 24541-3730 | 2020-08-04 |
| 1578983557 | Thomas Nevers | Radiology | 100 N Academy Ave, Danville, PA 17822-3628 | 2014-04-17 |
| 1932548567 | Joshua Nicholas Pitzen | Radiology | 100 N Academy Ave, Danville, PA 17822-0001 | 2013-06-17 |
| 1477990521 | Matthew David Hermann | Radiology | 100 N Academy Ave, Danville, PA 17822 | 2013-05-30 |
| Find all providers in DANVILLE | ||||
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| 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.