PETER PETRENKO (NPI# 1770574147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770574147 |
| Entity Type | Individual |
| Full Name | PETER PETRENKO |
| Credential | MD |
| Practice Address |
1 S Creek Dr Monticello KY 42633-9472 |
| Practice Telephone | 6063483365 |
| Practice Fax Number | 6063488496 |
| Mailing Telephone | 6063483365 |
| Mailing Fax Number | 6063488496 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2010-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34553 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64018799 | 05 |
| Street Address |
1 S CREEK DR |
| City | MONTICELLO |
| State | KY |
| Zip Code | 42633-9472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083604391 | Ronald M Mcfarland | Family Medicine | 1 S Creek Dr, Ste. 102, Monticello, KY 42633-9472 | 2005-10-27 |
| 1932658945 | London Valu-rite Pharmacy | Durable Medical Equipment & Medical Supplies | 1 S Creek Dr, Monticello, KY 42633-9472 | 2016-10-03 |
| 1497178347 | Misty A Cundiff | Nurse Practitioner | 1 S Creek Dr, Ste. 102, Monticello, KY 42633-9472 | 2014-01-29 |
| 1780903070 | David B Mayer D O P S C | Surgery | 1 S Creek Dr, Suite 112, Monticello, KY 42633-9472 | 2010-05-26 |
| 1407869571 | London Valu-rite Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 1 S Creek Dr, Monticello, KY 42633-9472 | 2006-08-13 |
| 1720049901 | Pamela A Molloy | Family Medicine | 1 S Creek Dr, Suite # 102, Monticello, KY 42633-9472 | 2006-03-29 |
| 1740262112 | Samuel M Brown | Physical Therapist | 1 S Creek Dr, Ste 116, Monticello, KY 42633-9472 | 2005-11-18 |
| 1700868601 | Linda J Brown | Physical Therapist | 1 S Creek Dr, Suite 116, Monticello, KY 42633-9472 | 2005-11-16 |
| 1902897309 | Richard B Mayer II | Family Medicine | 1 S Creek Dr, Ste 102, Monticello, KY 42633-9472 | 2005-11-03 |
| 1164413597 | Phillips Pratt Mcfarland Psc | Clinical Medical Laboratory | 1 S Creek Dr, Ste 102, Monticello, KY 42633-9472 | 2005-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963431 | Morgan Dishman | Pharmacist | 126 Franklin Dr, Monticello, KY 42633 | 2020-08-20 |
| 1942847686 | Burgess Drug Store Inc. | Pharmacy | 1 S. Creek Dr., Ste. #122, Monticello, KY 42633 | 2019-12-02 |
| 1639729460 | Lake Cumberland Therapy Center, Inc. | Developmental Therapist | 153 High Street, Monticello, KY 42633 | 2019-09-13 |
| 1053964965 | Faith Healthcare Inc | Nurse Practitioner | 126 Franklin Drive, Monticello, KY 42633 | 2019-07-19 |
| 1669936621 | Alisa D Wallace | Case Manager/Care Coordinator | 803 Columbia Ave, Monticello, KY 42633 | 2019-01-24 |
| 1194232207 | Jacob Dudley Coffey | Nurse Practitioner | 1 S Creek Dr Ste 102606, Monticello, KY 42633 | 2018-01-10 |
| 1245581578 | Joleen Nyesa Levering | Pharmacist | 1078 North Main Streeet, Monticello, KY 42633 | 2012-09-26 |
| 1194085977 | Steven M Tallent II | Dentist | 1225 N. Main St., Brummett Cosmetic and Family Dentistry, Monticello, KY 42633 | 2012-05-25 |
| 1245376243 | Diagnostic Radiology of London | Specialist | 1455 E Hwy 90 By-pass Unit #4, Monticello, KY 42633 | 2007-01-29 |
| 1639241433 | Hicks Enterprises of Monticello, LLC | Nursing Facility/Intermediate Care Facility | 1801 W. Hwy. 90 By-pass, Monticello, KY 42633 | 2006-11-15 |
| Find all providers in zip 42633 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679914675 | Mitchell Hammel | Family Medicine | 100 W Washington St Ste 101, Monticello, IL 61856-1713 | 2013-07-08 |
| 1700225679 | Michael Ray Nielson | Family Medicine | 380 W. 100 North, Monticello, UT 84535 | 2013-06-24 |
| 1740415611 | Julia Danielle Nicholson | Family Medicine | 906 Roberts Drive, Monticello, AR 71655 | 2009-05-21 |
| 1053566232 | Monticello Family Medicine & Walk-in Center | Family Medicine | 10 Prince St Ste 7, Monticello, NY 12701-1919 | 2008-12-01 |
| 1326248774 | James Wyatt Stephens | Family Medicine | 128 Courthouse Sq, Monticello, MS 39654-6014 | 2007-07-24 |
| 1548464993 | Fredy H Cordova | Family Medicine | 766 Hl Ross Dr, Monticello, AR 71655 | 2007-06-11 |
| 1629141494 | Bonita C Musial | Family Medicine | 314 Main St., Suite D, Monticello, MS 39654-0949 | 2006-11-17 |
| 1851463707 | Brantley B. Pace | Family Medicine | 713 Watts St., Monticello, MS 39654 | 2006-11-15 |
| 1790865624 | Christine M Foster | Family Medicine | 1293 N Main St Ste 102, Monticello, KY 42633-1945 | 2006-10-16 |
| 1962598490 | Abraham G. Garfinkel | Family Medicine | 15 Hamilton Ave, Monticello, NY 12701-1319 | 2006-10-04 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 42633 |
Please comment or provide details below to improve the information on PETER PETRENKO.
| 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.