=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033046677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEXINGTON RADIATION THERAPY CENTER, P.S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2026
-----------------------------------------------------
Last Update Date | 05/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1401 HARRODSBURG RD STE A100
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40504-3746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-258-6505
-----------------------------------------------------
Fax | 859-258-6509
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1221 S BROADWAY
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40504-2701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-258-6200
-----------------------------------------------------
Fax | 859-258-6203
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | JASON LADD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-258-4116
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------