KURT JAENICKE (NPI# 1073671673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073671673 |
Entity Type | Individual |
Full Name | KURT JAENICKE |
Credential | MD |
Practice Address |
1600 Medical Center Dr Ste 4500 Huntington WV 25701-3655 |
Practice Telephone | 3046911400 |
Enumeration Date | 2006-12-05 |
Last Update Date | 2020-07-01 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207V00000X | Obstetrics & Gynecology | 16950 | WV | Allopathic & Osteopathic Physicians |
N | 207V00000X | Obstetrics & Gynecology | 31309 | KY | Allopathic & Osteopathic Physicians |
Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
16950 | WV | Allopathic & Osteopathic Physicians |
N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
31309 | KY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | ANTHEM BCBS | 000000583794 | 01 |
OH | 0163719 | 05 | |
KY | ANTHEM BCBS | 000000510048 | 01 |
KY | 64313091 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
2001 Winchester Ave, Ashland, KY 411017743 | 6063247351 | 6063247359 |
Street Address |
1600 MEDICAL CENTER DR STE 4500 |
City | HUNTINGTON |
State | WV |
Zip Code | 25701-3655 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386289064 | Leanna Carlyn Profitt | Nurse Practitioner | 1600 Medical Center Dr Ste 4500, Huntington, WV 25701-3655 | 2019-11-17 |
1265922751 | Niccia Ditrapano | Student in an Organized Health Care Education/Training Program | 1600 Medical Center Dr Ste 4500, Huntington, WV 25701-3655 | 2018-05-10 |
1831689314 | Katherine Addicott | Student in an Organized Health Care Education/Training Program | 1600 Medical Center Dr Ste 4500, Huntington, WV 25701-3655 | 2018-05-10 |
1497245989 | Melissa Nehls | Student in an Organized Health Care Education/Training Program | 1600 Medical Center Dr Ste 4500, Huntington, WV 25701-3655 | 2018-05-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922607803 | Sara Tonya Hicks | Technician | 742 4th Avenue, Huntington, WV 25701 | 2020-10-21 |
1316550791 | Ethan Scott Miller | Counselor | 1538 Charleston Ave., Huntington, WV 25701 | 2020-08-26 |
1336752674 | Brock Riley Hapney | Student in an Organized Health Care Education/Training Program | 1538 Charelston Avenue, Huntington, WV 25701 | 2020-08-26 |
1558972224 | Ardith Ruth Bartram | Technician | 4045 C 8th Street Road, Huntington, WV 25701 | 2020-08-14 |
1144839614 | Randall Edward Short | Behavior Technician | 10th Sixth Avenue West, Huntington, WV 25701 | 2020-07-30 |
1609495191 | Melanie Jean Howard | Pharmacist | 1538 Charleston Avenue, Huntington, WV 25701 | 2020-04-14 |
1205472016 | Kelly Kauffer | Technician | 1012 Johns Court, Huntington, WV 25701 | 2019-11-27 |
1265082648 | Matt France | Technician | 3650 Taymor Rd, Huntington, WV 25701 | 2019-09-17 |
1538649348 | Kathryn Markus | Pharmacist | 1500 Medical Center Drive, Huntington, WV 25701 | 2018-08-21 |
1487155636 | Heather Marie Rogers | Nurse Practitioner | 940 4th Ave, Huntington, WV 25701 | 2018-02-23 |
Find all providers in zip 25701 |
Taxonomy Code | 207VF0040X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Female Pelvic Medicine and Reconstructive Surgery |
A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
City | HUNTINGTON |
Zip Code | 25701 |
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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.