1255359642 NPI number — J SCOTT MAYS D.P.M.

Table of content: J SCOTT MAYS D.P.M. (NPI 1255359642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255359642 NPI number — J SCOTT MAYS D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYS
Provider First Name:
J
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255359642
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N EAGLE CREEK DR
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40509-1805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-258-5900
Provider Business Mailing Address Fax Number:
859-258-5905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 N EAGLE CREEK DR
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40509-1827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-258-5900
Provider Business Practice Location Address Fax Number:
859-258-5905
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  00277 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0000X , with the licence number: 00277 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 00277 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 243959 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CB5773 . This is a "RR MEDICARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80000631 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: ASC1019 . This is a "MEDICARE ASC GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00184663 . This is a "RR MEDICARE PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37903705 . This is a "MEDICAID LAB GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 36000818 . This is a "MEDICAID ASC GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 4000501 . This is a "MEDICARE LAB GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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