DR. WAYNE LAWRENCE IVERSON (NPI# 1447397906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447397906 |
| Entity Type | Individual |
| Full Name | DR. WAYNE LAWRENCE IVERSON |
| Credential | M.D. |
| Practice Address |
1300 W Lexington Ave Ste 3 Winchester KY 40391-1154 |
| Mailing Address |
Po Box 4197 Winchester KY 40392-4197 |
| Practice Telephone | 8595130078 |
| Mailing Telephone | 8595130078 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-03-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
50617 | KY | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G30486 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICAL LICENSE | 50617 | 01 |
| KY | 7100563520 | 05 | |
| CA | MEDICAL LINCENSE | G30486 | 01 |
| KY | CLIA | 05D0569343 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15644 Pomerado Rd, Suite 100, Poway, CA 920642419 | 8586746184 | 8586744540 |
| Street Address |
1300 W LEXINGTON AVE STE 3 |
| City | WINCHESTER |
| State | KY |
| Zip Code | 40391-1154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255838710 | Sharrock Strength and Rehab LLC | Clinic/Center | 1932 Bypass Road, Winchester, KY 40391 | 2018-04-11 |
| 1316264385 | Yvonne Marie Pendleton | Massage Therapist | 126 Professional Ave., Winchester, KY 40391 | 2010-04-29 |
| 1346478310 | Mack Anderson Kidd IIi | Registered Nurse | 105 Lindberg Rd., Winchester, KY 40391 | 2009-06-29 |
| 1043487572 | Rankin Douglas Skinner | Dentist | 726 Boonesboro Plaza, Winchester, KY 40391 | 2008-05-14 |
| 1427233592 | Clark County Health Department | Public Health or Welfare | 244 E. Broadway, Shearer Elementary School, Winchester, KY 40391 | 2008-01-08 |
| 1437334505 | Clark County Health Department | Public Health or Welfare | 250 N. Main St., Fannie Bush Elementary, Winchester, KY 40391 | 2008-01-08 |
| 1598886251 | Winchester Open Mri | Radiology | 475 Shoppers Village Drive, Winchester, KY 40391 | 2007-04-02 |
| 1265509285 | James Warren Rice | Orthopaedic Surgery | 400 Shoppers Dr, Winchester, KY 40391 | 2006-11-29 |
| 1932279262 | J Todd Scobee Dmd Psc | Clinic/Center | 1216 West Lexington Ave, Winchester, KY 40391 | 2006-11-08 |
| 1396823936 | Commonwealth Urology, Psc | Urology | 68 East Elkin Street, Stanton, KY 40391 | 2006-11-01 |
| Find all providers in zip 40391 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679991095 | Swetha Penmasta Alluri | Internal Medicine | 1870 Amherst St Ste 100, Winchester, VA 22601-6254 | 2014-04-02 |
| 1821366923 | Arrhythmia Specialists, PC | Internal Medicine | 1870 Amherst St., 1-c, Winchester, VA 22601 | 2011-12-05 |
| 1588780514 | James Carter Laidlaw | Internal Medicine | Mob II, 190 Campus Blvd Suite 430, Winchester, VA 22601-6718 | 2007-03-21 |
| 1316974637 | Mircea M Basaraba | Internal Medicine | 155 Hospital Rd Ste G, Winchester, TN 37398-2495 | 2006-06-26 |
| 1871559773 | Ajay Virmani | Internal Medicine | 650 Cedar Creek Grade Ste 100, Winchester, VA 22601 | 2006-04-21 |
| 1841279916 | Juan Pittaluga | Internal Medicine | 817 Cedar Creek Grade, Suite 100, Winchester, VA 22601-2706 | 2006-01-17 |
| 1871596924 | Philip J O'donnell | Internal Medicine | 104 Selma Dr, Winchester, VA 22601-3834 | 2005-05-23 |
| 1124554357 | Winchester Physician Associates Inc | Internal Medicine | 1021 Main Street, Suite 1, Winchester, MA 01890 | 2017-05-09 |
| 1356756795 | Idean Amirjazil | Internal Medicine | 1870 Amherst St Ste 100, Winchester, VA 22601-6254 | 2014-06-24 |
| 1922418185 | Daniel Christian Hobbs | Internal Medicine | 1870 Amherst Street, Suite 100 and Suite 200, Winchester, VA 22601 | 2014-04-28 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 40391 |
Please comment or provide details below to improve the information on DR. WAYNE LAWRENCE IVERSON.
| 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.