Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207XS0117X | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 28014 | KENTUCKY | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 200103760A | MEDICAID | INDIANA | |
| 2 | 64280142 | MEDICAID | KENTUCKY | |
| 3 | 2433677000 | OTHER | KENTUCKY | PASSPORT ADVANTAGE (SPINE |
| 4 | 667790 | OTHER | KENTUCKY | CIGNA (UNIVERSITY ORTHOPA |
| 5 | P00764026 | OTHER | KENTUCKY | RAILROAD MEDICARE- NORTON LEATHERMAN SPINE CENTER |
| 6 | 00533158 | OTHER | KENTUCKY | MEDICARE- NORTON LEATHERMAN SPINE CENTER |
| 7 | 163722400 | OTHER | | US DEPT OF LABOR |
| 8 | 36123 | OTHER | KENTUCKY | CIGNA (SPINE INSTITUTE) |
| 9 | 1049632 | OTHER | KENTUCKY | PASSPORT (UNIVERSITY ORT |
| 10 | 1054523 | OTHER | KENTUCKY | PASSPORT (SPINE INSTITUTE |
| 11 | 200103760 | OTHER | KENTUCKY | HEALTHY INDIANA PLAN- COMMUNITY MEDICAL ASSOCIATES |
| 12 | 200103760 | MEDICAID | INDIANA | |
| 13 | 000000628569 | OTHER | KENTUCKY | ANTHEM- NORTON LEATHERMAN SPINE CENTER |
| 14 | 200027304 | OTHER | KENTUCKY | RAILROAD MEDICARE |
| 15 | 2432609000 | OTHER | KENTUCKY | PASSPORT ADVANTAGE (UNIVE |
| 16 | 3728039000 | OTHER | KENTUCKY | PASSPORT ADVANTAGE- NORTON LEATHERMAN SPINE CENTER |
| 17 | N293520 | OTHER | KENTUCKY | HARMONY (SPINE INSTITUTE) |
| 18 | 000000049467 | OTHER | KENTUCKY | ANTHEM (SPINE INSTITUTE) |
| 19 | 000051983J | OTHER | KENTUCKY | HUMANA- NORTON LEATHERMAN SPINE CENTER |
| 20 | 000000049352 | OTHER | KENTUCKY | ANTHEM (UNIVERSITY ORTHOP |
| 21 | 50024963 | OTHER | KENTUCKY | PASSPORT- NORTON LEATHERMAN SPINE CENTER |
| 22 | 8856267 | OTHER | KENTUCKY | CIGNA- NORTON LEATHERMAN SPINE CENTER |