Provider Demographics
NPI:1508868423
Name:JENNINGS, JAMES T (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4950 NORTON HEALTHCARE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2846
Practice Address - Country:US
Practice Address - Phone:502-394-6200
Practice Address - Fax:502-394-6210
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY33020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY05576736OtherAETNA- NORTON MEDICAL ASSOCIATES
KY5405014OtherCIGNA- NMA
KY000057119POtherHUMANA- NORTON MEDICAL ASSOCIATES
KY000000712878OtherANTHEM- NMA
KY7100158380Medicaid
KY50032791OtherPASSPORT- NORTON MEDICAL ASSOCIATES
KYP00933107OtherRAILROAD MEDICARE- NORTON MEDICAL ASSOCIATES
KYK002060Medicare PIN
KYP00933107OtherRAILROAD MEDICARE- NORTON MEDICAL ASSOCIATES
KY50032791OtherPASSPORT- NORTON MEDICAL ASSOCIATES
KY7100158380Medicaid