Provider Demographics
NPI:1205944568
Name:CENTRAL RADIOLOGY ASSOCIATES, LLP
Entity type:Organization
Organization Name:CENTRAL RADIOLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-260-6152
Mailing Address - Street 1:PO BOX 70335
Mailing Address - Street 2:CENTRAL RADIOLOGY ASSOCIATES
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40270-0335
Mailing Address - Country:US
Mailing Address - Phone:606-864-9697
Mailing Address - Fax:606-864-8411
Practice Address - Street 1:1740 NICHOLASVILLE RD
Practice Address - Street 2:CENTRAL BAPTIST HOSPITAL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:606-864-9697
Practice Address - Fax:606-864-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65904492Medicaid
KY5696OtherBLUE CROSS BLUE SHIELD
KY2846Medicare PIN