BERNARD THEODORE BOTILLER (NPI# 1588674865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588674865 |
| Entity Type | Individual |
| Full Name | BERNARD THEODORE BOTILLER |
| Credential | PA-C |
| Practice Address |
1451 Harrodsburg Road Suite D 304 Lexington KY 40504 UM |
| Mailing Address |
6400 Dutchmans Pkwy Suite 250 Louisville KY 40205-3340 |
| Practice Telephone | 8599774000 |
| Practice Fax Number | 8599775100 |
| Mailing Telephone | 5025879660 |
| Mailing Fax Number | 5025405615 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2016-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA674 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA674 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 95002739 | 05 |
| Street Address |
1451 HARRODSBURG ROAD SUITE D 304 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417043258 | Carole J Gould | Nurse Anesthetist, Certified Registered | 1451 Harrodsburg Road, Building D Suite 102, Lexington, KY 40504 | 2006-10-05 |
| 1679669519 | Brenda J Farmer | Nurse Anesthetist, Certified Registered | 1451 Harrodsburg Road, Building D, Suite 102, Lexington, KY 40504 | 2006-10-05 |
| 1619063484 | Pamela E Harris | Anesthesiology | 1451 Harrodsburg Road, Building D Suite 102, Lexington, KY 40504 | 2006-10-05 |
| 1821183872 | Jane E Fields | Anesthesiology | 1451 Harrodsburg Road, Building D Suite 102, Lexington, KY 40504 | 2006-10-04 |
| 1538255260 | Roberta F. Parker | Nurse Anesthetist, Certified Registered | 1451 Harrodsburg Road, Building D Suite 102, Lexington, KY 40504 | 2006-10-04 |
| 1326133992 | Lexington Anesthesia, Psc | Nurse Anesthetist, Certified Registered | 1451 Harrodsburg Road, Building D, Suite 102, Lexington, KY 40504 | 2006-10-03 |
| 1174618599 | Karen L Kiviniemi | Nurse Anesthetist, Certified Registered | 1451 Harrodsburg Road, Building D Suite 102, Lexington, KY 40504 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740809953 | Michael Jason Blocker | Registered Nurse | 1 St Hoseph Drive, Lexington, KY 40504 | 2020-04-09 |
| 1841842010 | Jessica Brooke Castleberry | Counselor | Chrysalis House, Inc., 1589 Hill Rise Drive, Lexington, KY 40504 | 2019-07-09 |
| 1528554474 | Hillcrest Pain & Spine Pllc | Pain Medicine | 853 Lane Allen Rd Ste 217, Lexington, KY 40504 | 2018-07-03 |
| 1366962474 | Jessica Hope King | Dentist | 1330 Harrodsburg Road, Lexington, KY 40504 | 2017-06-21 |
| 1255861076 | Mary Elizabeth Bailey | Dentist | 1330 Harrodsburg Rd, Lexington, KY 40504 | 2017-06-14 |
| 1295172211 | Alan Kidon | Podiatrist | 1401 Harrodsburg Rd Ste C115, Lexington, KY 40504 | 2013-05-31 |
| 1578847554 | Linda W Mcdaniel | Pharmacist | 2181 Harrodsburg Road, Lexington, KY 40504 | 2011-10-07 |
| 1578844197 | Amber Kincaid Ballard | Nurse Practitioner | Uk Healthcare Team Blue Primary Care Clinic, 2400 Great Stone Point, Lexington, KY 40504 | 2011-09-09 |
| 1104118124 | Harry W Tenfelde IIi | Pharmacist | 2284 Versailles Rd., Lexington, KY 40504 | 2011-05-10 |
| 1831495506 | Horizon Headache Center, Pllc | Physical Therapist | 2365 Harrodsburg Road, Suite B-100, Lexington, KY 40504 | 2011-01-28 |
| Find all providers in zip 40504 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282095 | Alison Deanne Power | Physician Assistant | 3209 Keithshire Way, Lexington, KY 40503-3481 | 2020-10-09 |
| 1588270110 | Reid Van Bussum | Physician Assistant | 913 Fiddler Creek Way, Lexington, KY 40515-6460 | 2020-09-18 |
| 1790394583 | Mary Luz Calderon | Physician Assistant | Uk Pediatric Neonatology, 800 Rose St 4th Fl, Lexington, KY 40536 | 2020-07-28 |
| 1689283731 | Corine Maria Van Gessel | Physician Assistant | 800 Rose Street Neonatal Intensive Care Unit, Lexington, KY 40536-0001 | 2020-07-24 |
| 1942827183 | Michael Dale Anthony Farran | Physician Assistant | 1401 Harrodsburg Rd Ste C405, Lexington, KY 40504-1748 | 2020-07-04 |
| 1033735204 | Melissa Mccool | Physician Assistant | 525 Red Taffy Way, Lexington, SC 29073-2907 | 2020-06-23 |
| 1598389421 | Storm Bryant Dutton | Physician Assistant | Uk Emergency Department - Chandler, 1000 S Limestone, Lexington, KY 40536 | 2020-06-06 |
| 1265056428 | Bernard L Bell | Physician Assistant | 838 Bryan Ave Apt 2, Lexington, KY 40505-3540 | 2020-06-03 |
| 1720601545 | Tyler Allen Pape | Physician Assistant | Uk Surgery Clinic - General, 740 S Limestone Ste L104, Lexington, KY 40536 | 2020-05-27 |
| 1417579269 | Kacy Clinkenbeard | Physician Assistant | Uk Healthcare-icu, 800 Rose St, Lexington, KY 40536 | 2020-05-15 |
| Find all providers in LEXINGTON | ||||
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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.