RENAISSANCE PLASTIC SURGERY PLLC (NPI# 1154342350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154342350 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE PLASTIC SURGERY PLLC |
| Practice Address |
2601 Kentucky Ave Ste 401 Paducah KY 42003-3827 |
| Mailing Address |
2601 Kentucky Ave Ste 401 Paducah KY 42003 |
| Practice Telephone | 2704448200 |
| Practice Fax Number | 2704448398 |
| Mailing Telephone | 2704448200 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-12-03 |
| Authorized Official Name | MR. DANIEL M TKACH (OWNER) |
| Authorized Official Telephone | 2704448200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65907685 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366603359 | Renaissance Plastic Surgery Pllc | Plastic Surgery | 5880 Ashmill Dr Ste 200, Plano, TX 75024-0031 | 2008-06-23 |
| Street Address |
2601 KENTUCKY AVE STE 401 |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003-3827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418473 | Western Kentucky Heart & Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2601 Kentucky Ave, Ste 300, Paducah, KY 42003-3826 | 2005-06-22 |
| 1023520434 | Baptist Healthcare System Inc | Pharmacy | 2601 Kentucky Ave, Medical Park 1, Suite 101, Paducah, KY 42003-3817 | 2017-10-26 |
| 1053857912 | Ashley C Jenks | Nurse Practitioner | 2601 Kentucky Ave, Suite 301, Paducah, KY 42003-3817 | 2017-01-16 |
| 1922550300 | Shakira N Bell | Nurse Practitioner | 2601 Kentucky Ave, Suite 301, Paducah, KY 42003-3817 | 2016-11-01 |
| 1447709159 | Kelly Nichols | Nurse Practitioner | 2601 Kentucky Ave, Suite 300, Paducah, KY 42003-3817 | 2016-09-23 |
| 1417403049 | Erin Walker Toombs | Nurse Practitioner | 2601 Kentucky Ave, Suite 103, Paducah, KY 42003-3817 | 2016-09-01 |
| 1255701173 | Kristena R Lea | Nurse Practitioner | 2601 Kentucky Ave, Suite 103, Paducah, KY 42003-3817 | 2015-10-05 |
| 1891164349 | Blair Brockman | Nurse Practitioner | 2601 Kentucky Ave, Suite 301, Paducah, KY 42003-3817 | 2015-09-15 |
| 1346624962 | Jasmaine Theobald | Nurse Practitioner | 2601 Kentucky Ave, Suite 103, Paducah, KY 42003-3817 | 2015-07-14 |
| 1407246853 | Kasey Murphy | Nurse Practitioner | 2601 Kentucky Ave, Suite 301, Paducah, KY 42003-3817 | 2015-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164441275 | Daniel M Tkach | Plastic Surgery | 2601 Kentucky Ave, Ste 401, Paducah, KY 42003-3827 | 2006-07-19 |
| 1851329122 | Peter Allan Ward | Plastic Surgery | 242 Berger Rd, Paducah, KY 42003-4522 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235544602 | Ashley Boustany | Plastic Surgery | University of Ky 800 Rose St, Lexington, KY 40536-0001 | 2014-06-24 |
| 1952720880 | Commonwealth Plastic Surgery, Pllc | Plastic Surgery | 715 Shaker Dr Ste 100, Lexington, KY 40504-3674 | 2014-04-08 |
| 1366885675 | Morgan Brgoch | Plastic Surgery | Uk Surgery Clinic - Plastic Surgery, 740 S Limestone Ste E101, Lexington, KY 40536-0284 | 2013-04-17 |
| 1861752909 | Frank Ryan Wermeling | Plastic Surgery | 4001 Kresge Way Ste 220, Louisville, KY 40207-4640 | 2012-05-23 |
| 1578879300 | Anil Duggal | Plastic Surgery | 740 S Limestone St E101, Lexington, KY 40536-4412 | 2010-08-31 |
| 1518287044 | Sonata Plastic Surgery, Pllc | Plastic Surgery | 3260 Blazer Pkwy, Suite 102, Lexington, KY 40509-2116 | 2010-06-07 |
| 1982924817 | Ashley Rawson Kerekes | Plastic Surgery | 511 Robinbrooke Blvd, Suite 100, Elizabethtown, KY 42701-5904 | 2010-06-02 |
| 1245464387 | John Bradley Turner | Plastic Surgery | 3288 Eagle View Ln, Suite 300, Lexington, KY 40509-9020 | 2009-05-04 |
| 1164688909 | Stephen Alexander Schantz | Plastic Surgery | 3288 Eagle View Ln Ste 300, Lexington, KY 40509-9019 | 2008-07-31 |
| 1144492638 | Theodore L. Gerstle | Plastic Surgery | 3363 Tates Creek Rd Ste 209, Lexington, KY 40502 | 2008-03-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RENAISSANCE PLASTIC SURGERY PLLC.
| 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.