TWIN LAKES MEDICAL FOUNDATION, INC (NPI# 1114234077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114234077 |
| Entity Type | Organization |
| Organization Name | TWIN LAKES MEDICAL FOUNDATION, INC |
| Other Organization Name | QUICKCARE NURSE PRACTITIONER GROUP |
| Practice Address |
1895 Elizabethtown Rd. Leitchfield KY 42754-9138 |
| Practice Telephone | 2702300182 |
| Practice Fax Number | 2702300014 |
| Mailing Telephone | 2702300182 |
| Mailing Fax Number | 2702300014 |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2013-06-11 |
| Authorized Official Name | LOUETTA ELLIOTT (BUSINESS ADMINISTRATION) |
| Authorized Official Telephone | 2702599580 |
| Is Organization Subpart | Y |
| Parent Organization Name | TWIN LAKES MEDICAL FOUNDATION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100150260 | 05 | |
| KY | ANTHEM BCBS | 000000698114 | 01 |
| Other Name | Type Code |
|---|---|
| QuickCare Nurse Practitioner Group | Doing Business As Name - Organization |
| Street Address |
1895 ELIZABETHTOWN RD. |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-9138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033401088 | Cova Teresa Stidham | Nurse Practitioner | 1895 Elizabethtown Rd., Leitchfield, KY 42754-9138 | 2011-05-10 |
| 1952616070 | Twin Lakes Medical Foundation, Inc. | Preventive Medicine | 1895 Elizabethtown Rd., Leitchfield, KY 42754-9138 | 2010-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851680128 | Regina Marie Marcinek | Clinical Nurse Specialist | 800 Rose Street Room Mn-524, University of Kentucky, Lexington, KY 40536-0298 | 2011-04-07 |
| 1275631749 | Deborah Joyce Mcdonald-ferko | Clinical Nurse Specialist | 7419 Cedar Bluff Ct, Prospect, KY 40059-7404 | 2006-09-20 |
| 1104230598 | Melissa Johnson | Clinical Nurse Specialist | 300 S 8th St, Ste 480w, Murray, KY 42071-2400 | 2014-06-13 |
| 1134433931 | Deborah Lynn Bray | Clinical Nurse Specialist | 1532 Lone Oak Rd, Suite 415, Paducah, KY 42003-7913 | 2010-08-04 |
| 1720275332 | Rhonda D. Casey | Clinical Nurse Specialist | 3991 Dutchmans Ln, Suite 405, Louisville, KY 40207-4700 | 2007-09-27 |
| 1184810541 | Tara L Lykins | Clinical Nurse Specialist | 1532 Lone Oak Rd, Suite 415, Paducah, KY 42003-7913 | 2007-09-19 |
| 1184657652 | Karen A. Mulholland | Clinical Nurse Specialist | 1221 S Broadway, Lexington, KY 40504-2701 | 2006-07-08 |
| 1083666085 | Elizabeth M. Archer-nanda | Clinical Nurse Specialist | 4001 Dutchmans Ln, Suite G-02, Louisville, KY 40207-4714 | 2006-05-17 |
| City | LEITCHFIELD |
| Zip Code | 42754 |
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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.