KC LTC GERIATRIC SPECIALTY PLLC (NPI# 1659704518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659704518 |
| Entity Type | Organization |
| Organization Name | KC LTC GERIATRIC SPECIALTY PLLC |
| Practice Address |
1312 Nivens Rd Benton MS 39039-9132 |
| Practice Telephone | 6622511550 |
| Mailing Telephone | 6622511550 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |
| Authorized Official Name | KIM RATCLIFF (MEMBER) |
| Authorized Official Telephone | 6622511550 |
| Authorized Official Credential | ACNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1312 NIVENS RD |
| City | BENTON |
| State | MS |
| Zip Code | 39039-9132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629012034 | Kimberly R Ratcliff | Nurse Practitioner | 1312 Nivens Rd, Benton, MS 39039-9132 | 2006-06-15 |
| 1154741502 | Lifecare Solutions LLC | Nurse Practitioner | 1312 Nivens Rd, Benton, MS 39039-9132 | 2014-04-24 |
| 1134490865 | Lifecare Solutions | Nurse Practitioner | 1312 Nivens Rd, Benton, MS 39039-9132 | 2012-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902300874 | Hattie Lee Haralson | Homemaker | 3825 Campbell Road, Benton, MS 39039 | 2018-03-23 |
| 1952608911 | William M Myers Jr. | Contractor | 1449 Sunny Lane Rd, Benton, MS 39039-9400 | 2011-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134264 | Stephanie Suzanne Worth | Physical Therapy Assistant | 135 Meyers Lake Ct, Benton, MO 63736-9201 | 2020-11-05 |
| 1346841517 | Samuel Wolf | Pharmacist | 17309 Interstate 30 S, Benton, AR 72015-2927 | 2020-11-04 |
| 1386244838 | Dana L Henson | Pharmacist | 3958 Hampton Dr, Benton, AR 72019-7609 | 2020-10-26 |
| 1649879750 | Prime Medical Group Pllc | Dermatology | 5 Medical Park Dr Ste 200, Benton, AR 72015-3732 | 2020-10-20 |
| 1285231043 | Harold Anthony Flood | Nurse Practitioner | 114 E 20th St, Benton, KY 42025-1721 | 2020-10-05 |
| 1619574555 | Brian Scott Burks | Nurse Practitioner | 4109 Hartford Hills Dr, Benton, AR 72019-2540 | 2020-10-05 |
| 1225645674 | Change Academy At Lake of The Ozarks | Psychiatric Residential Treatment Facility | 5842 Highway 30, Benton, TN 37307-4734 | 2020-09-29 |
| 1588270581 | Wk Palmetto Family Practice | Family Medicine | 4200 Palmetto Rd, Benton, LA 71006-9420 | 2020-09-16 |
| 1194330233 | Candace D Younger | Licensed Practical Nurse | 507 Lickliter St, Benton, IL 62812-2219 | 2020-09-15 |
| 1104439355 | Jason Amyx | Counselor | 78 Caky Dr, Benton, KY 42025-7592 | 2020-08-27 |
| Find all providers in BENTON | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285231043 | Harold Anthony Flood | Nurse Practitioner | 114 E 20th St, Benton, KY 42025-1721 | 2020-10-05 |
| 1366089740 | Katelyn Layne Ledbetter | Nurse Practitioner | 8 Summerwood Dr, Benton, AR 72019-1925 | 2019-12-05 |
| 1629012034 | Kimberly R Ratcliff | Nurse Practitioner | 1312 Nivens Rd, Benton, MS 39039-9132 | 2006-06-15 |
| 1942808217 | Megan Wheat | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2020-10-09 |
| 1861019721 | Traci C Crump | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2020-06-26 |
| 1134767627 | Penny Kaye Bettis | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2019-12-15 |
| 1073031878 | Jennifer Faughn Neighbors | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2017-09-01 |
| 1376999607 | Sarah Elizabeth Reyna | Nurse Practitioner | 1 Medical Park Dr, Suite 200, Benton, AR 72015-3353 | 2016-05-05 |
| 1417333188 | Regina Bennett | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2015-08-05 |
| 1205236551 | Bobbie Leanna Reed | Nurse Practitioner | 1 Medical Park Dr, Benton, AR 72015-3353 | 2014-08-23 |
| Find all providers in BENTON | ||||
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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.