JENNIFER TERESA SPRAGUE (NPI# 1033628268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033628268 |
| Entity Type | Individual |
| Full Name | JENNIFER TERESA SPRAGUE |
| Practice Address |
20 Medical Village Dr Edgewood KY 41017-5401 |
| Mailing Address |
2300 Chamber Center Dr Lakeside Park KY 41017-1686 |
| Practice Telephone | 8593014723 |
| Practice Fax Number | 8593014724 |
| Mailing Telephone | 8593014723 |
| Mailing Fax Number | 8593014724 |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | TC639 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942744 | Jennifer M Sprague | Counselor | 337 Se Fowler St, Roseburg, OR 97470-4348 | 2020-08-10 |
| 1184234346 | Jennifer Lynn Sprague | Counselor | 8150 Wornall Rd, Kansas City, MO 64114-5806 | 2020-08-03 |
| 1184146003 | Jennifer Rachel Sprague | Case Manager/Care Coordinator | 811 Madison St, Everett, WA 98203-4543 | 2017-07-12 |
| 1295152494 | Jennifer Sprague | Psychiatry & Neurology | 938 W Nelson St, Chicago, IL 60657 | 2014-03-25 |
| 1972836518 | Jennifer Lyn Sprague | Optometrist | 35 State Hospital Dr, Bangor, ME 04401-8816 | 2009-09-15 |
| 1568691541 | Jennifer Sprague | Social Worker | 5681 E Fowler Ave, Tampa, FL 33617-2307 | 2009-07-10 |
| 1033379714 | Jennifer Sprague | Nurse Practitioner | 1 Cameron Hill Cir, Chattanooga, TN 37402-9815 | 2008-06-16 |
| 1477739472 | Jennifer Eryn Sprague | Pediatrics | 1 Childrens Pl Ste C, Ste C, Saint Louis, MO 63110-1002 | 2008-01-21 |
| Street Address |
20 MEDICAL VILLAGE DR |
| City | EDGEWOOD |
| State | KY |
| Zip Code | 41017-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295243 | Paul Allen Jacobs | Obstetrics & Gynecology | 20 Medical Village Dr, Ste 302, Edgewood, KY 41017-5402 | 2005-06-14 |
| 1043821085 | David Thomas Tackett | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-08-13 |
| 1245866888 | Annalee Fitzpatrick | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-03-16 |
| 1972137313 | Thomas Gravely | Pharmacist | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-02-25 |
| 1205487071 | Amanda M Hofmeyer | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2019-09-24 |
| 1528535804 | Heidi Ann Ducker | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2018-10-25 |
| 1316433014 | Tara Nagaraj | Pharmacist | 20 Medical Village Dr, Edgewood, KY 41017 | 2018-07-05 |
| 1235658857 | Eric Joseph Faris | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017 | 2017-09-14 |
| 1356876940 | Jennifer Vaden | Registered Nurse | 20 Medical Village Dr, Suite 301, Edgewood, KY 41017-5401 | 2017-04-20 |
| 1346798303 | Robert Allen Brungs | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017 | 2016-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| 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 |
|---|---|---|---|---|
| 1811543812 | Emily Crocetti | Physician Assistant | 20 Medical Village Dr Ste 132, Edgewood, KY 41017-5406 | 2019-08-15 |
| 1053528380 | Casey Lynn Doty | Physician Assistant | 20 Medical Village Dr # 254, Edgewood, KY 41017 | 2007-05-17 |
| 1083212344 | Kelly O'brien | Physician Assistant | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2020-10-09 |
| 1255957122 | Lauren Slabaugh | Physician Assistant | 162 Barnwood Dr, Edgewood, KY 41017-2501 | 2020-06-17 |
| 1700422995 | Samuel Jacob Dedden | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2019-11-21 |
| 1700368495 | Brian R Ingram | Physician Assistant | 1851 Old Hwy 66, Edgewood, NM 87015 | 2018-08-30 |
| 1932624707 | Thomas Slone Wilkinson | Physician Assistant | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2017-08-13 |
| 1215380100 | Madeleine Lansberry | Physician Assistant | 200 Medical Village Dr, Edgewood, KY 41017 | 2016-07-15 |
| 1922463918 | Nicholas Joseph Reist | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2015-12-18 |
| 1275903320 | Jaclyn Lunsford | Physician Assistant | 200 Medical Village Dr, Edgewood, KY 41017 | 2015-10-01 |
| Find all providers in EDGEWOOD | ||||
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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.