CHEVY CHASE PRIMARY CARE LLC (NPI# 1104459502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104459502 |
| Entity Type | Organization |
| Organization Name | CHEVY CHASE PRIMARY CARE LLC |
| Practice Address |
330 Romany Rd Lexington KY 40502-2404 |
| Practice Telephone | 8592697337 |
| Practice Fax Number | 8593350157 |
| Mailing Telephone | 8592697337 |
| Mailing Fax Number | 8593350157 |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | MR. JAMES C OWEN (OWNER) |
| Authorized Official Telephone | 8592697337 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | NPI | 1063981231 | 01 |
| KY | NPI | 1669453635 | 01 |
| Street Address |
330 ROMANY RD |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40502-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669453635 | James C Owen | General Practice | 330 Romany Rd, Lexington, KY 40502-2404 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689213761 | Justin Waldo | Social Worker | Lexington Va Medical Center, 1101 Veteran's Drive, Lexington, KY 40502 | 2020-01-06 |
| 1275187569 | Lorraine Wiley | Specialist/Technologist | 712 Sports Center Dr, Lexington, KY 40502 | 2019-07-25 |
| 1013560952 | Erica Keller Musgrave | Speech-Language Pathologist | 882 Mcmeekin Pl, Lexington, KY 40502 | 2019-07-19 |
| 1174029078 | Michael Bryan Mullen | Otolaryngology | 358 Duke Rd, Lexington, KY 40502 | 2018-04-01 |
| 1346740644 | Susan R Castle | Physical Therapist | 710 East Main Street, Lexington, KY 40502 | 2018-02-14 |
| 1689187684 | Lynn Kathryn Marsh Bryant | Speech-Language Pathologist | 120 Kentucky Avenue, Suite 110 Lexington, Lexington, KY 40502 | 2017-11-13 |
| 1215440888 | Ryan Mcnamara | Specialist/Technologist | 277 Sports Center Drive, Lexington, KY 40502 | 2017-11-06 |
| 1336667690 | Anthony Shawn Prater | Physical Therapist | 710 E. Main St., Lexington, KY 40502 | 2017-09-06 |
| 1568989002 | Lucie Thurman | Counselor | 1109 Richmond Rd., Lexington, KY 40502 | 2017-08-25 |
| 1548700867 | Ann Elizabeth Boone | Massage Therapist | 2121 Richmond Road, Suite 228, Lexington, KY 40502 | 2017-03-06 |
| Find all providers in zip 40502 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1467908095 | Careatc - Leggett & Platt - Lexington, Nc | Clinic/Center | 3040 Junior Order Home Road, Lexington, NC 27292 | 2016-09-01 |
| 1518217389 | Wade D Reynolds Do, LLC | Clinic/Center | 111 Ivy Park Ln, Suite C, Lexington, SC 29072-8289 | 2012-09-19 |
| 1023266509 | Family First Medical Clinic | Clinic/Center | 21 W Church St, Lexington, TN 38351-2009 | 2008-09-08 |
| 1013905710 | Transsouth Healthcare PC | Clinic/Center | 120 E Church St, Lexington, TN 38351-1821 | 2005-10-07 |
| 1538527254 | Viphealth LLC | Clinic/Center | 117 Park Place Ct, Lexington, SC 29072-6690 | 2016-02-09 |
| 1952736035 | Cotton Grove Family Physicians, Pllc | Clinic/Center | 1926 Cotton Grove Rd, Lexington, NC 27292-5722 | 2013-09-09 |
| Find all providers in LEXINGTON | ||||
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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.