1750873527 NPI number — ALYSSA JOLENE TOPPEN MSOT

Table of content: ALYSSA JOLENE TOPPEN MSOT (NPI 1750873527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750873527 NPI number — ALYSSA JOLENE TOPPEN MSOT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOPPEN
Provider First Name:
ALYSSA
Provider Middle Name:
JOLENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSOT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOAGLAND
Provider Other First Name:
ALYSSA
Provider Other Middle Name:
JOLENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750873527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 S BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40504-2701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-258-6200
Provider Business Mailing Address Fax Number:
859-258-6203

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1207 S BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-2701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-258-8519
Provider Business Practice Location Address Fax Number:
859-258-8592
Provider Enumeration Date:
06/06/2018

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: 225X00000X , with the licence number:  242022 , 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: 7100543180 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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