MAG MEDICAL (NPI# 1063766012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063766012 |
| Entity Type | Organization |
| Organization Name | MAG MEDICAL |
| Practice Address |
21154 Hwy 421 Hyden KY 41749 |
| Practice Telephone | 6066721144 |
| Practice Fax Number | 6066721145 |
| Mailing Telephone | 6066721144 |
| Mailing Fax Number | 6066721145 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |
| Authorized Official Name | MS. PAULA FIELDS (CO-OWNER) |
| Authorized Official Telephone | 6066721144 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3006479 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255676094 | Mag Medical | Clinic/Center | 30 Old Mill Ridge Hl, Bonnyman, KY 41719-8841 | 2012-12-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MAG MEDICAL DIAGNOSTIC, P.C. | 18 Cliff Street, West Orange, New Jersey 07052 |
| New York State Corporations | MAG MEDICAL ENTERPRISES, INC. | 359 Violet St, Massapequa Park, New York 11762 |
| System for Award Management (SAM) Entities | MAG MEDICAL EQUIPMENT LLC | 216 W 38th St Ste C, Boise, ID 83714-6554 |
| Street Address |
21154 HWY 421 |
| City | HYDEN |
| State | KY |
| Zip Code | 41749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114417706 | Jerrica Sizemore | Occupational Therapist | 21040 Us-421, Hyden, KY 41749 | 2018-05-18 |
| 1356864623 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 21287 Hwy 421, Hyden, KY 41749 | 2017-07-19 |
| 1629527304 | Jacob Charles Williams | Pharmacist | 21287 Highway 421, Hyden, KY 41749 | 2016-09-23 |
| 1811277973 | Richard B Morgan | Pharmacist | 21154 Highway 421 South, Hyden, KY 41749 | 2011-08-22 |
| 1245522747 | Ma Angelica Sunga Buenaventura | Pharmacist | 21154 Highway 421, Hyden, KY 41749 | 2011-05-03 |
| 1598097362 | Teresia Davidson-griffith | Counselor | 28 Firehouse Lane, Hyden, KY 41749 | 2010-02-04 |
| 1740411826 | Rebecca Ann Burkhardt | Pharmacist | 22044 Main St., Hyden, KY 41749 | 2009-08-06 |
| 1104000447 | Doris Smith-whitaker | Social Worker | 28 Fire House Lane, Hyden, KY 41749 | 2007-12-21 |
| 1861671851 | Tracey Angela Grigsby | Dietitian, Registered | 40 Moore Lane, Hyden, KY 41749 | 2007-10-26 |
| 1629276415 | Kentucky River District Health Department | Public Health or Welfare | 25 Eagle Lane, Hyden, KY 41749 | 2007-07-03 |
| Find all providers in zip 41749 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306039052 | Joann B Martin | Nurse Practitioner | 130 Kate Ireland Drive, Hyden, KY 41749-8500 | 2007-08-24 |
| 1295944775 | Nora C Hamlin | Nurse Practitioner | 96 Hwy 80 Hurts Creek Center, Hyden, KY 41749-8500 | 2007-05-22 |
| 1538149596 | Brian S Overbee | Nurse Practitioner | 21154 Highway 421 # 1, Hyden, KY 41749-8553 | 2006-01-18 |
| 1902886930 | Clara S Jefferis | Nurse Practitioner | 96 Hwy 80, Hyden, KY 41749 | 2006-01-17 |
| 1467432492 | Heidi A Froemke | Nurse Practitioner | 130 Kate Ireland Dr, Hyden, KY 41749 | 2006-01-17 |
| 1215578331 | Salma Ramadan | Nurse Practitioner | 195 School St, Hyden, KY 41749-4601 | 2019-09-30 |
| 1740831536 | Rebeccah Michelle Erhard | Nurse Practitioner | 195 School St, Hyden, KY 41749-4601 | 2019-09-24 |
| 1710537428 | Kyle Ethan Farmer | Nurse Practitioner | 130 Kate Ireland Dr, Hyden, KY 41749-9071 | 2019-09-14 |
| 1508361601 | Ryann Poerio | Nurse Practitioner | 96 Highway 80, Hyden, KY 41749-8500 | 2018-03-29 |
| 1235501487 | Kayla Sabo | Nurse Practitioner | 21154 Highway 421 # 1, Hyden, KY 41749-8553 | 2015-10-28 |
| Find all providers in HYDEN | ||||
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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.