Provider Demographics
NPI:1881623270
Name:ADAMS, KRISTI CAUDILL (MD)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:CAUDILL
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-4138
Mailing Address - Fax:859-258-4796
Practice Address - Street 1:800 ROSE ST # MS 119
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-2701
Practice Address - Country:US
Practice Address - Phone:859-257-1446
Practice Address - Fax:859-257-7572
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31999207ZC0500X, 207ZH0000X, 207ZP0102X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY220030412OtherRR MEDICARE PIN
KY37903705OtherMEDICAID LAB GROUP
KY64031180Medicaid
KY4000501OtherMEDICARE LAB GRP
KYCB5773OtherRR MEDICARE GROUP
H33437Medicare UPIN