JENNA LEIGH DISMORE WRINKLES


Address: 120 Executive Park, Louisville, KY 40207-4201
Phone: 5028557200

JENNA LEIGH DISMORE WRINKLES (NPI# 1780909952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780909952
Entity Type Individual
Full Name JENNA LEIGH DISMORE WRINKLES
Credential M.D.
Practice Address 120 Executive Park
Louisville
KY 40207-4201
Practice Telephone 5028557200
Mailing Telephone 5024099925
Mailing Fax Number 5029199780
Enumeration Date 2010-03-31
Last Update Date 2019-01-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207LP2900X Anesthesiology
Specialization: Pain Medicine
01075865A IN Allopathic & Osteopathic Physicians
Y 207LP2900X Anesthesiology
Specialization: Pain Medicine
47108 KY Allopathic & Osteopathic Physicians
N 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
47108 KY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN 201317930 05
KY 7100167720 05
AETNA PIN 5661958 01
CARESOURCE ID CS1612000141 01
ANTHEM PIN 000000963791 01

Office Location

Street Address 120 EXECUTIVE PARK
City LOUISVILLE
State KY
Zip Code 40207-4201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508862202 Lisa M Schmidt Nurse Practitioner 120 Executive Park, Louisville, KY 40207 2005-06-27
1568012896 Tracey Frederick Nurse Practitioner 120 Executive Park, Louisville, KY 40207-4201 2019-09-18
1538672373 Michele Mcclure Nurse Practitioner 120 Executive Park, Louisville, KY 40207-4201 2017-11-15
1316398977 Johnna C Shown Nurse Practitioner 120 Executive Park, Louisville, KY 40207 2016-06-24
1467840439 Mary Tonini Nurse Practitioner 120 Executive Park, Louisville, KY 40207-4201 2014-12-29
1306280177 Commonwealth Pain Associates, Pllc Anesthesiology 120 Executive Park, Louisville, KY 40207 2013-04-24
1205187861 Melanie Dawn Moore Nurse Practitioner 120 Executive Park, Louisville, KY 40207-4201 2012-09-24
1366751455 Nicholas Bryce Mullins Nurse Practitioner 120 Executive Park, Louisville, KY 40207-4201 2010-10-07
1679615686 Stephen Kyle Young Anesthesiology 120 Executive Park, Louisville, KY 40207 2007-02-13
1063583268 James W Jackson Jr. Anesthesiology 120 Executive Park, Louisville, KY 40207 2006-11-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780212688 Alexia Louise Bodamer Student in an Organized Health Care Education/Training Program 142 Chenoweth Lane, Lousiville, KY 40207 2020-03-28
1467918664 Amy Rock LLC Counselor 4010 Dupont Cir Ste 307, Louisville, KY 40207 2019-02-13
1649745191 Louisville Optometric Center, IIi, Psc Optometrist 285 Hubbards Lane, Suite 300, Louisville, KY 40207 2018-10-11
1184137440 Crimson Dove Counseling Services Inc Community/Behavioral Health 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 2017-11-09
1285157586 Dickerson Family Enterprise, LLC Non-emergency Medical Transport (VAN) 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 2017-07-19
1578085296 Cardiovascular Medical Specialists LLC Surgery 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 2017-07-14
1932636305 Devon Turley Prevention Professional 1017 Dupont Rd, Suite 1, Louisville, KY 40207 2017-05-17
1285095539 Emily Schwartz Crouch Marriage & Family Therapist 4010 Dupont Circle, Suite 582, Louisville, KY 40207 2016-03-15
1306201280 A A and Associates Approved Alcohol/drug Program Counselor 4006 Dutchmans Lane, Louisville, KY 40207 2015-12-21
1629433693 Jewish Hospital and St. Mary's Healthcare, Inc. General Acute Care Hospital 3290 Dutchmans Lane, Louisville, KY 40207 2015-12-17
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Taxonomy Information

Taxonomy Code 207LP2900X
Grouping Allopathic & Osteopathic Physicians
Classification Anesthesiology
Specialization Pain Medicine

Taxonomy Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447645403 Vinayak Nadar Anesthesiology 1013 N Dupont Sq Ste A, Louisville, KY 40207-4612 2015-04-06
1114311073 William Bickers Anesthesiology 530 S Jackson St Rm C2a01, Department of Anesthesiology and Perioperative Medicine, Louisville, KY 40202-1675 2015-03-27
1386088508 Brooke Bauer Anesthesiology 2400 Eastpoint Pkwy Ste 410, Louisville, KY 40223-4154 2013-04-18
1609854520 Michael C Cronen Anesthesiology 252 Whittington Parkway, Louisville, KY 40222-4904 2006-01-03
1053807206 Capitol Pain of Kentucky, Pllc Anesthesiology 3841 Ruckriegel Pkwy Ste 104, Louisville, KY 40299 2018-07-10
1992219174 Noelle Allison Lang Anesthesiology 11901 Standiford Plaza Dr, Louisville, KY 40229 2017-11-26
1457712366 Steven Thebaud Anesthesiology 530 S Jackson St Rm C2a03, Louisville, KY 40202-1675 2016-03-19
1740611185 University of Louisville Research Foundation Anesthesiology 530 S Jackson St, Louisville, KY 40202-1675 2013-12-11
1770716870 Portercare Adventist Health System Anesthesiology 80 Health Park Dr, Suite 270, Louisville, CO 80027-9584 2009-08-24
1174795181 Medical Specialists of Kentuckiana Anesthesiology 170 Dr Arla Way, Louisville, KY 40229-5427 2008-03-31
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Competitor

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City LOUISVILLE
Zip Code 40207

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Dataset Information

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.

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