1295736189 NPI number — PETER K KUMMANT MD

Table of content: PETER K KUMMANT MD (NPI 1295736189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295736189 NPI number — PETER K KUMMANT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUMMANT
Provider First Name:
PETER
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1295736189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E LIBERTY ST
Provider Second Line Business Mailing Address:
STE 800
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-330-7818
Provider Business Mailing Address Fax Number:
606-330-7825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12579 MAIN STREET
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
MARTIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41649-0910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-285-0681
Provider Business Practice Location Address Fax Number:
606-285-9843
Provider Enumeration Date:
08/02/2005

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: 208600000X , with the licence number:  034039-E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 46983 , 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: 0000678684 . This is a "SECURITY BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 020048938 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 219141 . This is a "UPMC FOR YOU" identifier . This identifiers is of the category "OTHER".
  • Identifier: CI6850 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: K146780 . This is a "MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 123225 . This is a "THREE RIVERS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2588679 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 678684 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1517401 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 678684 . This is a "KEYSTONE HEALTH PLAN WEST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1911411 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251828837 . This is a "DEVON HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0012567360003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 116818 . This is a "ANTHEM BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 219141 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5007868-001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7100312840 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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