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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 201317930 | 05 | |
KY | 7100167720 | 05 | |
AETNA PIN | 5661958 | 01 | |
CARESOURCE ID | CS1612000141 | 01 | |
ANTHEM PIN | 000000963791 | 01 |
Street Address |
120 EXECUTIVE PARK |
City | LOUISVILLE |
State | KY |
Zip Code | 40207-4201 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 40207 |
Taxonomy Code | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
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. |
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 |
Find all providers in LOUISVILLE |
City | LOUISVILLE |
Zip Code | 40207 |
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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.