BLUEGRASS XRAY PSC (NPI# 1124062906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124062906 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS XRAY PSC |
| Practice Address |
320 Loretto Rd Lebanon KY 40033-1300 |
| Mailing Address |
Po Box 182255 Columbus OH 43218-2255 |
| Practice Telephone | 2706925267 |
| Mailing Telephone | 5138522442 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-08-23 |
| Authorized Official Name | CHERYL L BAKER (PRESIDENT) |
| Authorized Official Telephone | 2706925267 |
| 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 |
|---|---|---|---|
| PASSPORT HEALTH | 50007610 | 01 | |
| PASSPORT ADVANTAGE | 2622933000 | 01 | |
| MEDICARE RAILROAD | DD5463 | 01 |
| Street Address |
320 LORETTO RD |
| City | LEBANON |
| State | KY |
| Zip Code | 40033-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747919 | James Adam Montgomery | Anesthesiology | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2005-08-19 |
| 1558632414 | Deborah L. Doyle | Nurse Anesthetist, Certified Registered | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2012-01-24 |
| 1184866030 | Kevin J. Croce, Md | Radiology | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2009-03-24 |
| 1285814657 | Glen Adam Richardson | Specialist/Technologist | 320 Loretto Rd, Spring View Rehabilitation Services, Lebanon, KY 40033-1300 | 2007-11-13 |
| 1427275098 | Walter David Montgomery | Emergency Medicine | 320 Loretto Rd, Lebanon, KY 40033 | 2007-04-18 |
| 1992849822 | Spring View Hospital LLC | Internal Medicine | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2007-02-16 |
| 1083757348 | Spring View Hospital LLC | Clinical Medical Laboratory | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2007-02-15 |
| 1922165950 | Spring View Hospital LLC | Medicare Defined Swing Bed Unit | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2007-01-02 |
| 1780746420 | Spring View Hospital LLC | General Acute Care Hospital | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2006-12-15 |
| 1215099593 | Atam Abbi | Emergency Medicine | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538636311 | One Cross Health Clinic, Inc. | Clinic/Center | 305 Koehler Drive, Lebanon, KY 40033 | 2018-10-30 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1003204892 | Mmhh, LLC | Clinic/Center | 135 E. Martin Luther King Ave., Lebanon, KY 40033 | 2014-12-31 |
| 1194964510 | Gregory W. Schall, Do, Pllc | Family Medicine | 312 W High Street, Lebanon, KY 40033 | 2009-02-09 |
| 1780859553 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 2136 Campbellsville Road, Lebanon, KY 40033 | 2008-04-23 |
| 1144491234 | William Duley IIi | Dentist | 219 West Main St, Lebanon, KY 40033 | 2008-03-17 |
| 1891965927 | Dana Michelle Logsdon | Nurse Practitioner | 727 W. Main St., Lebanon, KY 40033 | 2008-03-05 |
| 1669523684 | The Childrens Clinic, Pllc. | Pediatrics | 420 Loretta Road, Lebanon, KY 40033 | 2007-01-16 |
| 1215022348 | Marion County Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 320 Loretto Road, Lebanon, KY 40033 | 2006-10-04 |
| 1568479426 | Daniel Earl Bailey Jr. | Specialist | 420 Loretto Rd, Suite 600, Lebanon, KY 40033 | 2006-08-02 |
| Find all providers in zip 40033 | ||||
| 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 |
|---|---|---|---|---|
| 1114551132 | Lebanon Pet Scan Center, LLC | Radiology | 103 Physicians Way Ste 100, Lebanon, TN 37090-4129 | 2020-02-28 |
| 1417319161 | Joseph Martin Clark | Radiology | 16 E High St, Lebanon, PA 17042-5454 | 2016-03-22 |
| 1902900061 | Susan B Humphreys Md PC | Radiology | Carroll & Tate Streets, Lebanon, VA 24266 | 2006-09-11 |
| 1467499079 | Philip Dennison Stieg | Radiology | Fourth & Walnut Streets, Radiology Department, Lebanon, PA 17042-1281 | 2006-06-01 |
| 1285689513 | Vision Imaging of Lebanon LLC | Radiology | 805 Helen Dr, Lebanon, PA 17042-7493 | 2006-05-24 |
| 1902876352 | Radiology & Nuclear Medicine Associates | Radiology | 1411 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-01-26 |
| 1669469532 | Daniel William Hottenstein | Radiology | 231 Valley Rd, Lebanon, PA 17042-8930 | 2005-10-05 |
| 1811998073 | Susan Barrow Humphreys | Radiology | Carroll & Tate Sts, Box 3600, Lebanon, VA 24266 | 2005-08-09 |
| 1346246436 | Lebanon Diagnostic Imaging, LLC | Radiology | 960 Isabel Dr, Lebanon, PA 17042-7482 | 2005-06-23 |
| 1386175859 | Joshua Harris Litchman | Radiology | 1 Medical Dr, Lebanon, NH 03756 | 2017-03-25 |
| Find all providers in LEBANON | ||||
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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.