PINE MOUNTAIN EMERGENCY GROUP LIMITED LIABILITY COMPANY (NPI# 1568010064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568010064 |
| Entity Type | Organization |
| Organization Name | PINE MOUNTAIN EMERGENCY GROUP LIMITED LIABILITY COMPANY |
| Practice Address |
81 Ball Park Rd Harlan KY 40831-1701 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 6065738100 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |
| Authorized Official Name | LISHA C FALK (VP OF CONTRACTING) |
| Authorized Official Telephone | 8008939698 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
81 BALL PARK RD |
| City | HARLAN |
| State | KY |
| Zip Code | 40831-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054667 | Robin Magnani | Anesthesiology | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2005-06-22 |
| 1699399121 | Jordan Cecil Childers | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-06-01 |
| 1881218535 | Mythili Kanthi Gudipati | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-05-28 |
| 1831712546 | Tara G Hendrickson | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831 | 2020-05-28 |
| 1497389936 | Keith Allen Goddard | Physical Medicine & Rehabilitation | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-02-24 |
| 1801434493 | Alexis Barnes | Physical Therapist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-12-15 |
| 1497397863 | Casey Nicole Warf | Nurse Practitioner | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-10-17 |
| 1588216386 | Morgan Rutherford | Speech-Language Pathologist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-07-11 |
| 1841842648 | Arika Gibbs | Occupational Therapist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-07-11 |
| 1073173753 | Jane Katherine Heinold | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795261 | Hometown Urgent Care | Clinic/Center | 101 Green Terrace, Harlan, KY 40831 | 2020-09-21 |
| 1093243727 | Right Choice Counseling | Counselor | 53 Meadowbrook Lane, Harlan, KY 40831 | 2017-05-25 |
| 1639515935 | Harlan County Health Department Inc/ Cawood Elementary School | Public Health or Welfare | 51 Nola St, Cawood, KY 40831 | 2013-05-14 |
| 1487090775 | Harlan County Health Department Inc/james A Cawood Elementary School | Public Health or Welfare | 269 Ball Park Road, Harlan, KY 40831 | 2013-05-14 |
| 1336278175 | Newton Samuel Guy IIi | Dentist | 303 Mound St, Harlan, KY 40831 | 2007-03-05 |
| 1033256904 | Earlene A. Napier | Counselor | 15 Eula Gray Street, Harlan, KY 40831 | 2007-01-31 |
| 1538265400 | Kirpal S Sidhu | Orthopaedic Surgery | 29 Eula Gray Street, Harlan, KY 40831 | 2006-09-16 |
| 1508977067 | Gursharan Kaur Sidhu | Pediatrics | 29 Eula Gray St, Gursharan Kaur Sidhu Md, Harlan, KY 40831 | 2006-08-31 |
| 1649229725 | Timothy Logan Yost | Physical Therapist | 100 Professional Lane, Suite 102, Harlan, KY 40831 | 2006-05-08 |
| 1881693471 | Medical Services of America Inc | Emergency Response System Companies | 2307 W Hwy 72, Bldg B, Unit 2, Harlan, KY 40831 | 2005-07-18 |
| Find all providers in zip 40831 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194963843 | Mohammed M Rahman | Emergency Medicine | 858 Woodland Hls, Harlan, KY 40831-2569 | 2009-02-02 |
| 1912982075 | Bret D. Heileson | Emergency Medicine | 1220 Chatburn Avenue, Harlan, IA 51537 | 2005-12-13 |
| 1093897290 | Mountain Medical Enterprises, Pllc | Emergency Medicine | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2006-10-19 |
| 1235109067 | David G. Erlbacher | Emergency Medicine | 1220 Chatburn Avenue, Harlan, IA 51537 | 2006-01-24 |
| 1144213836 | Timothy E. Brelje | Emergency Medicine | 1220 Chatburn Ave, Harlan, IA 51537-2009 | 2005-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620768 | Rachel L Arnold | Emergency Medicine | 702 N Maple Ave, Danville, KY 40422-1147 | 2019-10-10 |
| 1154976405 | Larry Dale Melton | Emergency Medicine | 7712 Cambridge Ct, Crestwood, KY 40014-8932 | 2019-08-05 |
| 1811484264 | Bellefonte Physician Services, Inc. | Emergency Medicine | 1816 Carter Ave Ste 2, Ashland, KY 41101-7643 | 2018-04-20 |
| 1093210338 | Emily Marsh | Emergency Medicine | 50 Woodson Way, Glasgow, KY 42141-3245 | 2018-03-28 |
| 1215464839 | Robert A Hudepohl | Emergency Medicine | 2487 Legends Way, Crestview Hills, KY 41017-3480 | 2017-05-12 |
| 1851822696 | Jonathan Walrath | Emergency Medicine | 48 Achates Dr, Florence, KY 41042-9753 | 2017-03-23 |
| 1194187179 | Russell Paul Landry IIi | Emergency Medicine | 1303 Us Hwy 127 S Ste 402, 367, Frankfort, KY 40601 | 2016-03-28 |
| 1083076145 | Slade Thompson | Emergency Medicine | 800 Rose St University of Kentucky, Lexington, KY 40536-7001 | 2016-03-27 |
| 1285096834 | Michael Gleason | Emergency Medicine | 859.323 5083, 800 Rose St M-53, Lexington, KY 40536-0298 | 2016-03-23 |
| 1538543087 | David Sindler | Emergency Medicine | 3615 E John Rowan Blvd Ste 104, Bardstown, KY 40004-3264 | 2015-07-15 |
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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.