KELLY BURGESS M.D. NPI 1568629418

NPI Information

  • NPI: 1568629418
  • Provider Name: KELLY BURGESS M.D.
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 1140 LEXINGTON RD
    SUITE 200
    GEORGETOWN, KY
    ZIP 40324
  • Phone: (502) 863-5150

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NPI Details

KELLY BURGESS M.D. is a primary care clinic center in Georgetown, KY. KELLY BURGESS M.D. NPI is 1568629418. The provider is registered as an organization entity type.

The provider's business location address is:

1140 LEXINGTON RD
SUITE 200
GEORGETOWN, KY
ZIP 40324-330
Phone: (502) 863-5150
Fax: (502) 863-4487

The provider's authorized official is Kelly R Burgess .
The authorized official title is Doctor and has the following contact phone number (502) 863-5150.

The enumeration date for this NPI number is 5/19/2008 and was last updated on 6/18/2008.

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
1261QP2300XClinic/CenterPrimary CareYes

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
10974001MEDICARE PINKENTUCKY
2000000368877OTHERKENTUCKYBCBS
3G63969OTHERKENTUCKYUPIN
464017783MEDICAIDKENTUCKY

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: 11/21/2025

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