IROQUOIS MEDICAL CENTER,P.S.C. (NPI# 1164614368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164614368 |
| Entity Type | Organization |
| Organization Name | IROQUOIS MEDICAL CENTER,P.S.C. |
| Other Organization Name | IMC FAMILY MEDICINE |
| Practice Address |
1905 W Hebron Ln Suite 103 Shepherdsville KY 40165-7465 |
| Mailing Address |
5601 S 3rd St 100 Louisville KY 40214-2615 |
| Practice Telephone | 5029577580 |
| Practice Fax Number | 5029576667 |
| Mailing Telephone | 5023667720 |
| Mailing Fax Number | 5023660824 |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | MRS. NEVA ALLEN (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 5023667720 |
| Is Organization Subpart | Y |
| Parent Organization Name | IROQUOIS MEDICAL CENTER, P.S.C |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34540 | KY | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| IMC FAMILY MEDICINE | Former Legal Business Name - Organization |
| Street Address |
1905 W HEBRON LN SUITE 103 |
| City | SHEPHERDSVILLE |
| State | KY |
| Zip Code | 40165-7465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831182435 | Christopher W Hubbard | Podiatrist | 1905 W Hebron Ln, Shepherdsville, KY 40165-7465 | 2005-08-30 |
| 1376800680 | Comprehensive Foot & Ankle Centers | Durable Medical Equipment & Medical Supplies | 1905 W Hebron Ln, Suite 204, Shepherdsville, KY 40165-7465 | 2012-04-12 |
| 1821382284 | Scott Glen Hicks | Nurse Practitioner | 1905 W Hebron Ln, Shepherdsville, KY 40165-7465 | 2011-06-02 |
| 1023316908 | James T Dodge, D.o., LLC | Obstetrics & Gynecology | 1905 W Hebron Ln, Ste 205, Shepherdsville, KY 40165-7465 | 2011-03-02 |
| 1396905006 | Associates In General Surgery,psc | Surgery | 1905 W Hebron Ln, Ste 204, Shepherdsville, KY 40165-7465 | 2008-06-16 |
| 1972531879 | Cardiovascular Associates Psc | Internal Medicine | 1905 W Hebron Ln, Suite 202, Shepherdsville, KY 40165-7425 | 2006-06-29 |
| 1588642425 | Waqar A Saleem | Family Medicine | 1905 W Hebron Ln, Suite 103, Shepherdsville, KY 40165-7465 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357729 | Jennifer Gayle Stillwell | Licensed Practical Nurse | 202 Overlook Estates Drive, Shepherdsville, KY 40165 | 2020-08-18 |
| 1538701537 | Melody Lynn Royer | Technician | 164 Beagle Run, Shepherdsville, KY 40165 | 2019-10-10 |
| 1649726258 | Kentucky Cvs Pharmacy LLC | Pharmacy | 157 South Buckman Street, Shepherdsville, KY 40165 | 2016-09-01 |
| 1669866729 | Ashley Krages | Occupational Therapy Assistant | 143b Turtle Bay Ct Apt 5, Shepherdsville, KY 40165 | 2015-03-26 |
| 1548679020 | Debra F Schoenberg | Social Worker | 1305 S. Joe B Hall, Shepherdsviile, KY 40165 | 2014-08-08 |
| 1821438359 | Jon-michael Leblanc | Counselor | 130 S. Joe B. Hall Ave., Shepherdsville, KY 40165 | 2013-06-28 |
| 1750633178 | Lee Alan Roussel | Marriage & Family Therapist | 130 Joe B Hall, Shepherdsville, KY 40165 | 2012-10-09 |
| 1679822977 | Andrew T. Webb | Social Worker | 130 South Joe B. Hall Ave., Shepherdsville, KY 40165 | 2012-08-31 |
| 1306173737 | Enrica T Thomas | Social Worker | 815 John Harper Rd Unit 14, Shepherdsville, KY 40165 | 2009-11-05 |
| 1740452184 | Brian Woodring | Marriage & Family Therapist | 130 Vine St., Shepherdsville, KY 40165 | 2008-03-26 |
| Find all providers in zip 40165 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770950156 | Acer Health Inc | Family Medicine | 1553 Highway 44 E, Shepherdsville, KY 40165-7183 | 2015-09-01 |
| 1699032284 | Michele Fass | Family Medicine | 115 Huston Dr. Ste1, Shepherdsville, KY 40165-7520 | 2012-04-19 |
| 1821354820 | Samuel Terrell Vanover | Family Medicine | 3130 Bells Mill Road, Shepherdsville, KY 40165-6905 | 2012-04-04 |
| 1437214731 | Joseph Koenigsmark | Family Medicine | 407 Zinnia Way, Shepherdsville, KY 40165-9663 | 2006-12-27 |
| 1003871518 | Stephen C. Payne | Family Medicine | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2006-04-18 |
| 1003810987 | Charlotte Kay Ingwersen | Family Medicine | 187 Adam Shepherd Pkwy Ste 5, Shepherdsville, KY 40165-7500 | 2005-06-09 |
| 1407811771 | Susan G Johns | Family Medicine | 115 Huston Dr, Suite 1, Shepherdsville, KY 40165-7250 | 2006-04-19 |
| 1043275779 | James R Cundiff | Family Medicine | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2006-04-18 |
| 1588642425 | Waqar A Saleem | Family Medicine | 1905 W Hebron Ln, Suite 103, Shepherdsville, KY 40165-7465 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890431 | Alishia Gayle Euler | Family Medicine | 730 Della Dr, Lexington, KY 40504-3610 | 2020-11-01 |
| 1306443908 | Complete Wellness Inc | Family Medicine | 25 Joshua Lane, Hawesville, KY 42348 | 2020-10-06 |
| 1811503410 | Angela Coffman | Family Medicine | 1000 Thompson Dr, Beaver Dam, KY 42320-9152 | 2020-09-18 |
| 1871107375 | West Towne Clinical Services Pllc | Family Medicine | 2755 W Park Dr Ste 1, Paducah, KY 42001-9058 | 2020-09-02 |
| 1528670981 | Visium Healthlink LLC | Family Medicine | 507 Avawam Dr, Richmond, KY 40475-9195 | 2020-08-18 |
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1952929689 | Yasir LLC | Family Medicine | 103 Financial Pl Ste 300, Elizabethtown, KY 42701-4470 | 2020-07-09 |
| 1578188637 | Megan Elizabeth Burke | Family Medicine | 641 Zag Rd, West Liberty, KY 41472-7625 | 2020-06-14 |
| 1679197529 | Kentucky Mountain Interventional and Infusion Therapies, LLC. | Family Medicine | 101 Hibbard St Ste 200, Pikeville, KY 41501-1788 | 2020-06-05 |
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | SHEPHERDSVILLE |
| Zip Code | 40165 |
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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.