CLUBMD, LLC (NPI# 1447508809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
1065 ASHLEY ST SUITE 200 |
City | BOWLING GREEN |
State | KY |
Zip Code | 42103-3400 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
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 |
Find all providers in zip 42103 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598383572 | Enhance The Aesthetic & Wellness Co. | Clinic/Center | 801 Country Club Ln, Hopkinsville, KY 42240-1370 | 2020-07-07 |
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 |
1932611019 | Family Care Professional Limited Liability Company | Clinic/Center | 3190 Irvine Rd., Richmond, KY 40475-4047 | 2017-10-30 |
Find all providers with the same taxonomy |
City | BOWLING GREEN |
Zip Code | 42103 |
Please comment or provide details below to improve the information on CLUBMD, LLC.
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.