DR. MICKEY DALE ANDERSON (NPI# 1497728323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497728323 |
| Entity Type | Individual |
| Full Name | DR. MICKEY DALE ANDERSON |
| Credential | MD |
| Practice Address |
118 Patriot Dr Suite 203 Bardstown KY 40004-9093 |
| Mailing Address |
Po Box 936 London KY 40743-0936 |
| Practice Telephone | 5023485588 |
| Practice Fax Number | 5023481046 |
| Mailing Telephone | 6063307840 |
| Mailing Fax Number | 6063307825 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 20844 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64208440 | 05 |
| Street Address |
118 PATRIOT DR SUITE 203 |
| City | BARDSTOWN |
| State | KY |
| Zip Code | 40004-9093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478831 | Erika Goodlett | Nurse Practitioner | 118 Patriot Dr, Bardstown, KY 40004-9093 | 2019-10-15 |
| 1740692193 | Micah Greenwell | Nurse Practitioner | 118 Patriot Dr, Suite 102, Bardstown, KY 40004-9093 | 2014-05-20 |
| 1992063101 | Saint Joseph Medical Foundation, Inc. | Surgery | 118 Patriot Dr, Ste 203, Bardstown, KY 40004-9093 | 2012-04-25 |
| 1265729990 | Felicia Dawn Geron | Nurse Practitioner | 118 Patriot Dr, Suite 102, Bardstown, KY 40004-9093 | 2011-07-01 |
| 1508195587 | Home Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 118 Patriot Dr, Bardstown, KY 40004-9093 | 2009-12-21 |
| 1588844401 | Associates In General Surgery,psc | Surgery | 118 Patriot Dr, Bardstown, KY 40004-9093 | 2007-11-08 |
| 1639388861 | Medical Center Cardiologists, Psc | Internal Medicine | 118 Patriot Dr, Suite 103, Bardstown, KY 40004 | 2007-05-22 |
| 1790735306 | Nancy Mae Hale | Physician Assistant | 118 Patriot Dr, Suite 102, Bardstown, KY 40004-9093 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590880 | Flaget Healthcare, Inc | Clinic/Center | 4359 Shepherdsville Road, Ste 255, Bardstown, KY 40004 | 2020-08-28 |
| 1902421043 | Astra Recovery Centers, LLC | Substance Abuse Rehabilitation Facility | 202 Downs Lane, Bardstown, KY 40004 | 2020-06-15 |
| 1285296194 | Hardin Memorial Hospital | Pharmacy | 3615 E John Rowan Blvd, Bardstown, KY 40004 | 2019-07-01 |
| 1376024919 | Flaget Healthcare Inc | Clinic/Center | 110 N. Salem Drive, Bardstown, KY 40004 | 2018-08-22 |
| 1730697517 | Shannon Michelle Woods | Nurse Practitioner | 1095 Morton Ave, Bardstown, KY 40004 | 2018-01-16 |
| 1477922490 | Kristi Ballard | Counselor | 1000 E John Rowan Blvd Ste 107, Bardstown, KY 40004 | 2015-09-21 |
| 1659705309 | Patricia Hall | Speech-Language Pathologist | 310 South 6th Street, Bardstown, KY 40004 | 2013-08-29 |
| 1629314885 | Saint Joseph-anc Home Care Services, LLC | Hospice Care, Community Based | 711 Mcdowell Blvd, Bardstown, KY 40004 | 2012-12-17 |
| 1780920058 | Stars and Stripes Medical LLC | Durable Medical Equipment & Medical Supplies | 301 W. Stephen Foster Ave, Suite B., Bardstown, KY 40004 | 2012-12-14 |
| 1366790230 | Lynda Onyinyechi Uzonwune | Pharmacist | 202 West Stephen Foster Avenue, Bardstown, KY 40004 | 2012-08-26 |
| Find all providers in zip 40004 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245352533 | Thomas J Schory | Surgery | 4359 New Shepherdsville Rd, Suite 245, Bardstown, KY 40004-8000 | 2007-04-06 |
| 1467402925 | Timothy A Jones | Surgery | 4371 New Shepherdsville Rd Unit 100, Bardstown, KY 40004-8040 | 2006-05-12 |
| 1992184030 | Tyler B. Holley | Surgery | 4371 New Shepherdsville Rd Unit 100, Bardstown, KY 40004-8040 | 2015-05-21 |
| 1992063101 | Saint Joseph Medical Foundation, Inc. | Surgery | 118 Patriot Dr, Ste 203, Bardstown, KY 40004-9093 | 2012-04-25 |
| 1992937791 | Saint Joseph Medical Foundation, Inc | Surgery | 4359 New Shepherdsville Rd, Ste 205, Bardstown, KY 40004-8000 | 2009-08-13 |
| 1588844401 | Associates In General Surgery,psc | Surgery | 118 Patriot Dr, Bardstown, KY 40004-9093 | 2007-11-08 |
| 1245433051 | Robert Joseph Farrell Iv | Surgery | 4359 New Shepherdsville Rd, Bardstown, KY 40004-8000 | 2007-06-08 |
| 1871646539 | Bluegrass General Surgery | Surgery | 919 Chambers Blvd Ste D, Bardstown, KY 40004-2574 | 2007-01-18 |
| 1194833848 | Anderson & Bowlds Pllc | Surgery | 118 Patriot Drive, #203, Bardstown, KY 40004 | 2006-08-25 |
| 1326066648 | Richard C. Montgomery | Surgery | 4371 New Shepherdsville Rd Unit 100, Bardstown, KY 40004-8040 | 2006-07-17 |
| Find all providers in BARDSTOWN | ||||
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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.