PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC (NPI# 1891855359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891855359 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC |
| Practice Address |
111 Helmwood Plaza Dr Elizabethtown KY 42701-2480 |
| Practice Telephone | 2707374808 |
| Mailing Telephone | 2707374808 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-12-01 |
| Authorized Official Name | MARQUITA H BALL (PARTNER) |
| Authorized Official Telephone | 2707374808 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65929457 | 05 | |
| KY | PASSPORT GROUP NUMBER | 1054638 | 01 |
| Street Address |
111 HELMWOOD PLAZA DR |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-2480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174574446 | Melissa Bland Flynn | Pediatrics | 111 Helmwood Plaza Dr, Elizabethtown, KY 42701 | 2006-05-12 |
| 1144367533 | Veronica Hurst Cammack | Pediatrics | 111 Helmwood Plaza Dr, Elizabethtown, KY 42701-2480 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966778 | Member Medical, Inc. | Clinic/Center | 3046 Dolphin Dr Ste 104, Elizabethtown, KY 42701-7182 | 2019-11-07 |
| 1043736440 | Zipclinic, Psc | Clinic/Center | 2005 N Dixie Ave, Elizabethtown, KY 42701-9468 | 2017-08-17 |
| 1922443480 | Etown Family Practice Plc | Clinic/Center | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2013-05-09 |
| 1447430731 | Mccleerey Family Medicine LLC | Clinic/Center | 100 Helmwood Plaza Dr, Elizabethtown, KY 42701-2975 | 2007-11-05 |
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|---|---|---|---|---|
| 1598383572 | Enhance The Aesthetic & Wellness Co. | Clinic/Center | 801 Country Club Ln, Hopkinsville, KY 42240-1370 | 2020-07-07 |
| 1679192611 | Temple Triage Pllc | Clinic/Center | 8209 Pennsylvania Run Rd, Louisville, KY 40228-2143 | 2020-04-09 |
| 1104384213 | Directcare Family Health, Pllc | Clinic/Center | 525 High St Ste 209, Paris, KY 40361-1849 | 2019-03-07 |
| 1407311194 | Quad/med, LLC | Clinic/Center | 739 S Dixie St, Horse Cave, KY 42749 | 2019-02-06 |
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1134606403 | Hope Primary & Urgent Care Pllc | Clinic/Center | 2157 S Highway 27, Stearns, KY 42647-6297 | 2018-07-19 |
| 1780177618 | Access Med, Pllc | Clinic/Center | 642 E Lexington Ave, Danville, KY 40422-1719 | 2018-06-14 |
| 1447743760 | Remedy House Calls | Clinic/Center | 37 Christopher Dr, South Shore, KY 41175-9447 | 2018-06-12 |
| 1932611019 | Family Care Professional Limited Liability Company | Clinic/Center | 3190 Irvine Rd., Richmond, KY 40475-4047 | 2017-10-30 |
| 1780102301 | Communtiy Healthcare of Western Kentucky LLC | Clinic/Center | 308 South Washington Street Suite 200, Clinton, KY 42031 | 2017-09-04 |
| Find all providers with the same taxonomy | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
Please comment or provide details below to improve the information on PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC.
| 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.