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TRI-STATE GASTROENTEROLOGY ASSOCIATES PSC NPI 1306843842


NPI Information

NPI: 1306843842
Provider Name: TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
425 CENTRE VIEW BLVD
CRESTVIEW HILLS, KY
ZIP 41017
Phone: (859) 341-3575
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TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC is a clinic center in Crestview Hills, KY. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC NPI is 1306843842. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

425 CENTRE VIEW BLVD
CRESTVIEW HILLS, KY
ZIP 41017-409
Phone: (859) 341-3575
Fax: (859) 341-5701

The provider's authorized official is Daniel G Fagel .
The authorized official title is President and has the following contact phone number (859) 341-3575.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 10/7/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0100XInternal MedicineGastroenterologyNo
2207R00000XInternal MedicineNo
3363A00000XPhysician AssistantNo
4261Q00000XClinic/CenterYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100179230OTHERKENTUCKYKY MEDICAID PA GROUP
2200354220MEDICAIDINDIANA
3CM0475OTHERMEDICARE RAILROAD
46591623100MEDICAIDKENTUCKY
5000000032466OTHERANTHEM
678901550OTHERKENTUCKYKY MEDICAID NP GROUP
70835841MEDICAIDOHIO
83491MEDICARE PINKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.