MARK FAIRCHILD (NPI# 1255304598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255304598 |
| Entity Type | Individual |
| Full Name | MARK FAIRCHILD |
| Credential | PAC |
| Practice Address |
211 Ky 59 Vanceburg KY 41179-9701 |
| Mailing Address |
Po Box 550 Vanceburg KY 41179-0550 |
| Practice Telephone | 6067963029 |
| Practice Fax Number | 6067966221 |
| Mailing Telephone | 6067963029 |
| Mailing Fax Number | 6067966221 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2010-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA434 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 95002721 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043220940 | Mark C Fairchild | Psychiatry & Neurology | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2006-08-09 |
| Street Address |
211 KY 59 |
| City | VANCEBURG |
| State | KY |
| Zip Code | 41179-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157815 | Ramon L Barcelona | Family Medicine | 211 Ky 59, Vanceburg, KY 41179 | 2005-07-11 |
| 1881158434 | Nikki Lynn Moore | Nurse Practitioner | 211 Ky 59, Vanceburg, KY 41179-7647 | 2019-01-29 |
| 1700213105 | Judith Jill Bowling Jaggers | Registered Nurse | 211 Ky 59, Vanceburg, KY 41179 | 2013-09-30 |
| 1790088987 | Terrilee Hainline | Nurse Practitioner | 211 Ky 59, Vanceburg, KY 41179-7647 | 2010-12-10 |
| 1699905273 | Kacy Cluxton | Dietitian, Registered | 211 Ky 59, Vanceburg, KY 41179 | 2009-07-17 |
| 1831326305 | Emily Hughes | Dentist | 211 Ky 59, Vanceburg, KY 41179-7647 | 2009-06-11 |
| 1043336506 | Lewis County Primary Care Center, Inc | Clinic/Center | 211 Ky 59, Vanceburg, KY 41179-7647 | 2007-03-22 |
| 1659421907 | Ronald D Mays | Dentist | 211 Ky 59, Vanceburg, KY 41179-7647 | 2007-01-11 |
| 1487766614 | Lewis County Primary Care Center Pharmacy | Pharmacy | 211 Ky 59, Vanceburg, KY 41179-0550 | 2006-09-01 |
| 1114936192 | Kelly G Moss | Family Medicine | 211 Ky 59, Vanceburg, KY 41179-7647 | 2006-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033731278 | Seth Carroll | Pharmacist | Lewis County Primary Care Center, 211 Ky 59, Vanceburg, KY 41179 | 2020-05-11 |
| 1326699430 | Jackie Kelley | Technician | 19750 Ky 59, Vanceburg, KY 41179 | 2019-09-20 |
| 1487092862 | Portsmouth Emergency Ambulance Service Inc | Ambulance | 1006 Fairlane Drive, Vanceburg, KY 41179 | 2013-06-07 |
| 1740443050 | Glenda J Gayheart | Early Intervention Provider Agency | 8385 E Ky8, Vanceburg, KY 41179 | 2008-07-07 |
| 1568651016 | John D. O'cull Dentistry P.s.c. | Dentist | Rural Route 3037, Vanceburg, KY 41179 | 2007-10-22 |
| 1225237472 | Mary K. Mcclurg | Case Manager/Care Coordinator | Aa Highway, Vanceburg, KY 41179 | 2007-07-17 |
| 1295952604 | Lewis County Health Dept | Public Health or Welfare | 185 Commercial Drive, Lewis County Health Department, Vanceburg, KY 41179 | 2007-04-19 |
| 1982749032 | John D O'cull | Dentist | Route 3037, Vanceburg, KY 41179 | 2007-02-20 |
| 1275681934 | Martha L Parker | Dietitian, Registered | Rt 3 Box 31, Vanceburg, KY 41179 | 2007-01-08 |
| 1750320446 | Family Medical Center | Family Medicine | Hc 75 Box 1005, Vanceburg, KY 41179 | 2006-06-06 |
| Find all providers in zip 41179 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780657015 | Darla J Pickett | Physician Assistant | Rr 3, Vanceburg, KY 41179-9701 | 2006-02-08 |
| 1407829740 | Amy G Canary | Physician Assistant | 211 Ky 59, Vanceburg, KY 41179-7647 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364335 | Ryan Williamson | Physician Assistant | 1149 Delaney Ferry Rd, Nicholasville, KY 40356-8727 | 2020-07-27 |
| 1811518541 | Autumn Rose Ballard | Physician Assistant | 141 Mallard Dr, Frankfort, KY 40601-8647 | 2020-05-05 |
| 1558982348 | Damian Morriston | Physician Assistant | 7088 Aspen Grove Ct, Louisville, KY 40241-2522 | 2020-05-03 |
| 1063041457 | Molly Ritter | Physician Assistant | 2310 Woodbourne Ave Apt 13, Louisville, KY 40205-1752 | 2020-04-07 |
| 1710525944 | Aaron Dewayne Petrey | Physician Assistant | 475 N Highway 25 W Ste 100, Williamsburg, KY 40769-1576 | 2019-12-18 |
| 1437704921 | Daniel Lee Mullins | Physician Assistant | 122 Travis Way, Georgetown, KY 40324-0500 | 2019-08-02 |
| 1871150649 | East Ky Health Service Center | Physician Assistant | 566 Highway 899 # 849, Hindman, KY 41822-8955 | 2019-05-28 |
| 1629533310 | Michelle Ladanyi | Physician Assistant | 1140 Lexington Rd Ste 102, Georgetown, KY 40324-9330 | 2019-02-06 |
| 1629582739 | Addie C Rosenberger | Physician Assistant | 200 E Chestnut St Bldg Ste 303, Louisville, KY 40202-1831 | 2017-11-28 |
| 1255788725 | Affinity Health Care Psc | Physician Assistant | 22055 Main St, Hyden, KY 41749-8568 | 2016-05-15 |
| Find all providers with the same taxonomy | ||||
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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.