LESLIE PEMBERTON (NPI# 1003311036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003311036 |
| Entity Type | Individual |
| Full Name | LESLIE PEMBERTON |
| Credential | PA-C |
| Practice Address |
1065 Ashley St Ste 200 Bowling Green KY 42103-3401 |
| Mailing Address |
201 Park St Bowling Green KY 42101-1708 |
| Practice Telephone | 2708433376 |
| Practice Fax Number | 2707800481 |
| Mailing Telephone | 2708433376 |
| Mailing Fax Number | 2707800496 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | TP698 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285914747 | Leslie Maryann Pemberton | Pharmacist | 1200 Kuhl Ave, Orlando, FL 32806-1127 | 2011-08-27 |
| Street Address |
1065 ASHLEY ST STE 200 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42103-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649479460 | Jacqueline Granese | Dermatology | 1065 Ashley St Ste 200, Bowling Green, KY 42103-3401 | 2007-07-12 |
| 1467947267 | Sherelen Hodges | Nurse Practitioner | 1065 Ashley St Ste 200, Bowling Green, KY 42103 | 2018-06-25 |
| 1871083030 | Amber Lynn Riley | Nurse Practitioner | 1065 Ashley St Ste 200, Bowling Green, KY 42103 | 2018-05-14 |
| 1184062481 | Juliana Elyse Gilbert | Dermatology | 1065 Ashley St Ste 200, Bowling Green, KY 42103-3401 | 2013-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
| 1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
| 1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
| 1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
| 1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
| 1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
| 1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
| 1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| 1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
| Find all providers in zip 42103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801417100 | Samantha Tollerud | Physician Assistant | 8320 Middleton Pike, Bowling Green, OH 43402-9639 | 2020-04-28 |
| 1881247922 | Hayley Richardson Sechler | Physician Assistant | 1818 Wallace Ct Ste 301, Bowling Green, KY 42103-2462 | 2019-07-18 |
| 1568493823 | Amy E Etsell | Physician Assistant | 905 Highway 161, Bowling Green, MO 63334-2431 | 2006-07-05 |
| 1730186057 | Belinda A Heywood | Physician Assistant | 838 E Wooster St, Bowling Green, OH 43402-3186 | 2005-07-01 |
| 1295364982 | Sara Vodde | Physician Assistant | 1420 S Business 61 Ste Def, Bowling Green, MO 63334-5230 | 2020-04-03 |
| 1902370232 | Wil Casper Norviel | Physician Assistant | 8 Town Center Dr, Bowling Green, MO 63334-2803 | 2019-01-21 |
| 1982177457 | Rachael Katherine Grant | Physician Assistant | 1801 Ashley Cir, Bowling Green, KY 42104-3362 | 2019-01-08 |
| 1942781000 | Nayab I. Hussain | Physician Assistant | 484 Golden Autumn Way Ste 201, Bowling Green, KY 42103-6913 | 2018-08-27 |
| 1336649680 | Rachel Marklin | Physician Assistant | 484 Golden Autumn Way Ste 201, Bowling Green, KY 42103-6913 | 2018-02-13 |
| 1538668140 | Melissa M Crocker | Physician Assistant | 201 Park St, Bowling Green, KY 42101-1708 | 2018-02-09 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 42103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.