BLUEGRASS REGIONAL IMAGING LLC (NPI# 1417110842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417110842 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS REGIONAL IMAGING LLC |
| Practice Address |
211 Fountain Ct Suite 140 Lexington KY 40509-1888 |
| Mailing Address |
1218 S Broadway Ste 310 Lexington KY 40504-2759 |
| Practice Telephone | 8596297230 |
| Practice Fax Number | 8596297231 |
| Mailing Telephone | 8592190542 |
| Mailing Fax Number | 8592199433 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2015-10-02 |
| Authorized Official Name | DR. JON K KOSTELIC (MEMBER) |
| Authorized Official Telephone | 8592190542 |
| Authorized Official Credential | M.D. |
| 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 | 000000219100 | 01 |
| KY | 65935207 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669636486 | Bluegrass Regional Imaging LLC | Radiology | 1401 Harrodsburg Rd, C45, Lexington, KY 40504-3751 | 2008-07-10 |
| 1871542670 | Bluegrass Regional Imaging LLC | Radiology | 701 Bob O Link Dr, Suite 245, Lexington, KY 40504-3761 | 2006-05-09 |
| Street Address |
211 FOUNTAIN CT SUITE 140 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40509-1888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982672325 | Kay G Wilson | Nurse Practitioner | 211 Fountain Ct, Suite 210, Lexington, KY 40509-1888 | 2006-03-10 |
| 1003162546 | Indhira Bisono Jimenez | Internal Medicine | 211 Fountain Ct, Suite 220, Lexington, KY 40509-2694 | 2012-08-02 |
| 1689932527 | Sarah Michelle O'leary | Internal Medicine | 211 Fountain Ct, Suite 120, Lexington, KY 40509-2694 | 2012-04-29 |
| 1083864227 | Lucia Hardi | Internal Medicine | 211 Fountain Ct, Ste 210, Lexington, KY 40509-1888 | 2008-09-24 |
| 1841462322 | Caresse Lynnette Wesley | Family Medicine | 211 Fountain Ct, Ste 120, Lexington, KY 40509-1888 | 2008-03-25 |
| 1801081864 | Bijal Abheer Jayakar | Internal Medicine | 211 Fountain Ct, Suite 210, Lexington, KY 40509-2694 | 2007-09-12 |
| 1801090220 | Amberly K Windisch | Urology | 211 Fountain Ct, Ste 230, Lexington, KY 40509-1888 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453640 | Grace T. Hallak | Counselor | 513 Darby Creek Rd, Lexington, KY 40509 | 2019-08-19 |
| 1932755774 | Lexington-fayette Urban-county Health Department | Public Health or Welfare | 4801 Athens Boonesboro Rd, Lexington, KY 40509 | 2019-08-16 |
| 1497308266 | Discover You Counseling LLC | Social Worker | 513 Darby Creek Drive, Unit 56 D, Lexington, KY 40509 | 2019-07-22 |
| 1407323611 | Trevor Douglas Mchardy | Physician Assistant | 101 North Eagle Creek Drive, Lexington, KY 40509 | 2018-10-25 |
| 1114413184 | Megan Medrano | Dietitian, Registered | 163 Old Todds Rd Ste 115, Lexington, KY 40509 | 2018-07-02 |
| 1750884292 | Active Medical LLC | Durable Medical Equipment & Medical Supplies | 3470 Blazer Pkwy Ste 350, Lexington, KY 40509 | 2018-03-12 |
| 1699273599 | Frederick Douglas High School | Public Health or Welfare | 2000 Winchester Rd, Lexington, KY 40509 | 2018-01-25 |
| 1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
| 1164956397 | Danielle Anderson | Family Medicine | 24 Fountain Court, Suite 225, Lexington, KY 40509 | 2017-04-14 |
| 1356891782 | Dawn Jones | Physician Assistant | 101 N Eagle Creek Dr, Ste 120, Lexington, KY 40509 | 2016-10-10 |
| Find all providers in zip 40509 | ||||
| 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 |
|---|---|---|---|---|
| 1174037949 | Justin Byron Hall | Radiology | 3452 Milam Ln, Lexington, KY 40502-3652 | 2017-11-30 |
| 1750731048 | Brent A Pressman | Radiology | 800 Rose St Rm Hx-315, Lexington, KY 40536-1227 | 2016-06-16 |
| 1952783672 | Harit Kapoor | Radiology | 800 Rose St Rm No, Lexington, KY 40536-4818 | 2015-06-19 |
| 1003159047 | Gilroy Lane Daley Sr. | Radiology | 3111 Maria Drive, Lexington, KY 40516 | 2013-03-28 |
| 1629336573 | Chad Herman Barker | Radiology | Uk-gme, 800 Rose Street, Room Hq-101, Lexington, KY 40536-0001 | 2012-04-29 |
| 1194010561 | Aaron David Fain | Radiology | Ukmc Department of Radiology, 800 Rose Street, Lexington, KY 40536-0001 | 2011-06-14 |
| 1790077113 | Sarah Milam Deraney | Radiology | 800 Rose St # Hx316, Lexington, KY 40536-0001 | 2011-05-03 |
| 1851529424 | Miguel Alexis Pereira Rodriguez | Radiology | 800 Rose St # Hx315e, Lexington, KY 40536-0293 | 2009-06-23 |
| 1588810451 | Gaby Gabriel | Radiology | 800 Rose St Rm Hx-311, Lexington, KY 40536-0293 | 2008-08-12 |
| 1730343674 | Stephen Hobbs | Radiology | 800 Rose St Rm Hx302, University of Kentucky Hospital, Lexington, KY 40536-0001 | 2008-07-10 |
| 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.