HENDERSON PEDIATRICS, PSC (NPI# 1497088090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497088090 |
| Entity Type | Organization |
| Organization Name | HENDERSON PEDIATRICS, PSC |
| Practice Address |
1035 N Elm St Henderson KY 42420-2712 |
| Practice Telephone | 2708274596 |
| Mailing Telephone | 2708274596 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |
| Authorized Official Name | KIMBERLY K RUDD (BILLING SPECIALIST) |
| Authorized Official Telephone | 2708274596 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
40961 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100005530 | 05 | |
| KY | ANTHEM | 000000625514 | 01 |
| Street Address |
1035 N ELM ST |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-2712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003159997 | Deaconess Clinic, Inc | Nurse Practitioner | 1035 N Elm St, Henderson, KY 42420-2712 | 2013-03-29 |
| 1659665529 | Hometown Vision Care LLC | Optometrist | 1035 N Elm St, Henderson, KY 42420-2712 | 2011-06-08 |
| 1326359746 | Sara Lynn Sagez-barnett | Optometrist | 1035 N Elm St, Henderson, KY 42420-2712 | 2010-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659457935 | Michael L. Levin | Pediatrics | 220 E Horizon Dr Ste A, Henderson, NV 89015-8001 | 2006-10-28 |
| 1114003498 | Marcy A. Kulic | Pediatrics | 600 Whitney Ranch Dr Ste A1, Henderson, NV 89014-2631 | 2006-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154715159 | Gregory Tracy | Pediatrics | 3050 Harrodsburg Rd Ste 100, Lexington, KY 40503 | 2015-03-27 |
| 1679773154 | Sheila M Guelda Md Pllc | Pediatrics | 2809 N Hurstbourne Pkwy, Suite 109, Louisville, KY 40223-1279 | 2007-07-23 |
| 1235296617 | Suzanne L Woods | Pediatrics | 301 C Middletown Park Place, Louisville, KY 40243 | 2007-01-03 |
| 1811062151 | Winit Chartisathian | Pediatrics | 73 Kingswood Dr, Campbellsville, KY 42718-9604 | 2006-11-22 |
| 1871694174 | Angelito L Samson | Pediatrics | 150 Frankfort Rd, Suite 101, Shelbyville, KY 40065-9433 | 2006-09-26 |
| 1558376392 | Robert J Tagher | Pediatrics | 7409 Us Highway 42, Florence, KY 41042-1905 | 2006-07-30 |
| 1710947817 | Paul J Janson | Pediatrics | 7370 Turfway Road, Suite 280, Florence, KY 41042 | 2006-03-24 |
| 1457331555 | Debra R. Bailey | Pediatrics | 419 Town Mountain Road, Suite 202, Pikeville, KY 41501-1633 | 2006-01-17 |
| 1700863230 | Dana J Distler | Pediatrics | 301 Middletown Park Pl, Suite C, Louisville, KY 40243-2515 | 2005-12-27 |
| 1194719831 | John P Oliphant | Pediatrics | 3427 Stony Spring Cir, Louisville, KY 40220-5437 | 2005-09-08 |
| 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.