CLUBMD, LLC


Address: 1065 Ashley St, Suite 200, Bowling Green, KY 42103-3400
Phone: 2704670010

CLUBMD, LLC (NPI# 1447508809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447508809
Entity Type Organization
Organization Name CLUBMD, LLC
Practice Address 1065 Ashley St
Suite 200
Bowling Green
KY 42103-3400
Mailing Address Po Box 1094
Bowling Green
KY 42102-1094
Practice Telephone 2704670010
Enumeration Date 2012-08-16
Last Update Date 2012-08-16
Authorized Official Name ERIC WARREN BLETZINGER (VICE PRESIDENT)
Authorized Official Telephone 2707802825
Is Organization Subpart Y
Parent Organization Name CMD HOLDING, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 1065 ASHLEY ST
SUITE 200
City BOWLING GREEN
State KY
Zip Code 42103-3400

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225034267 Jo Ann Jones Dermatology 1065 Ashley St, Suite 200, Bowling Green, KY 42103-3400 2005-06-23
1093187304 Brianna Grider Physician Assistant 1065 Ashley St, Suite 200, Bowling Green, KY 42103-3400 2015-10-26
1710238266 Kyle Allen Herald Physician Assistant 1065 Ashley St, Bowling Green, KY 42103-3400 2012-09-24
1780946160 James Allred Dermatology 1065 Ashley St, Bowling Green, KY 42103-3400 2012-06-12
1902972441 Shannon Watkins Dermatology 1065 Ashley St, Suite 200, Bowling Green, KY 42103-3400 2006-11-27
1811969298 Wilfred Amiscua Lumbang Dermatology 1065 Ashley St, Bowling Green, KY 42103-3400 2006-02-01

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NPI Name Taxonomy Address Enumeration
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1063927671 James Toney Counselor 624 Eastwood St, Bowling Green, KY 42103 2017-12-05
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1033562632 Elizabette Raby Massage Therapist 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 2016-07-19
1831572460 Casey Edward Travelsted Dentist 940 Us 31 W Bypass, Bowling Green, KY 42103 2015-07-01
1821435074 Robert Louis Skaggs II Dermatology 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 2013-05-29
1770893257 Michelle Howell Health Educator 261 Moats Lane, Bowling Green, KY 42103 2010-10-18
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669626701 Ken Embry M.d. Clinic/Center 1733 Campus Plaza Ct Ste 5, Bowling Green, KY 42101-2996 2008-11-14
1003364373 Verdant Healthcare LLC Clinic/Center 1300 Andrea St, Suite 100, Bowling Green, KY 42104-3382 2016-09-15

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1679192611 Temple Triage Pllc Clinic/Center 8209 Pennsylvania Run Rd, Louisville, KY 40228-2143 2020-04-09
1154966778 Member Medical, Inc. Clinic/Center 3046 Dolphin Dr Ste 104, Elizabethtown, KY 42701-7182 2019-11-07
1104384213 Directcare Family Health, Pllc Clinic/Center 525 High St Ste 209, Paris, KY 40361-1849 2019-03-07
1407311194 Quad/med, LLC Clinic/Center 739 S Dixie St, Horse Cave, KY 42749 2019-02-06
1265906192 Core Chiropractic and Family Wellness Pllc Clinic/Center 524 E.second St, Lexington, KY 40508 2019-01-14
1134606403 Hope Primary & Urgent Care Pllc Clinic/Center 2157 S Highway 27, Stearns, KY 42647-6297 2018-07-19
1780177618 Access Med, Pllc Clinic/Center 642 E Lexington Ave, Danville, KY 40422-1719 2018-06-14
1447743760 Remedy House Calls Clinic/Center 37 Christopher Dr, South Shore, KY 41175-9447 2018-06-12
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Competitor

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City BOWLING GREEN
Zip Code 42103

Improve Information

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Dataset Information

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.

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