GREEN VALLEY RURAL CLINICS, LLC (NPI# 1962602821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962602821 |
| Entity Type | Organization |
| Organization Name | GREEN VALLEY RURAL CLINICS, LLC |
| Practice Address |
156 Island Creek Rd Pikeville KY 41501-9340 |
| Mailing Address |
Po Box 2748 Pikeville KY 41502-2748 |
| Practice Telephone | 6064323221 |
| Practice Fax Number | 6064370438 |
| Mailing Telephone | 6064323221 |
| Mailing Fax Number | 6064370438 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2012-11-01 |
| Authorized Official Name | MR. DJIEN H. SO (ADMINISTRATOR) |
| Authorized Official Telephone | 6064323221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65925638 | 05 |
| Street Address |
156 ISLAND CREEK RD |
| City | PIKEVILLE |
| State | KY |
| Zip Code | 41501-9340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104816982 | M Zuhdi Alimam | Pediatrics | 156 Island Creek Rd, Pediatric Associates, Pikeville, KY 41501-9340 | 2005-10-24 |
| 1467997940 | Sarah Ann Coleman | Nurse Practitioner | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2016-12-20 |
| 1730518424 | Erica Blackburn | Nurse Practitioner | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2013-11-04 |
| 1821304676 | Imp Health Services Inc | Clinical Medical Laboratory | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2010-08-30 |
| 1679702492 | Bernie Justice | Nurse Practitioner | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2009-07-14 |
| 1740359934 | General Medical Lab | Clinical Medical Laboratory | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2006-11-06 |
| 1326091463 | Alvin Scott Little | Physician Assistant | 156 Island Creek Rd, Asthma & Allergy Center, Pikeville, KY 41501 | 2006-05-18 |
| 1053382788 | Medical Investment Trust | Nurse Practitioner | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2006-01-31 |
| 1376533091 | Leonor Salamanca Pagtakhan So | Allergy & Immunology | 156 Island Creek Rd, Pikeville, KY 41501-9340 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720634 | Lauren Ann Thacker | Nurse Practitioner | 648 Stonehenge Drive, Pikeville, KY 41501 | 2020-11-03 |
| 1659933406 | Wesley Tyler Rowe | Pharmacist | 553 Hambley Boulevard, Suite 6, Pikeville, KY 41501 | 2019-07-02 |
| 1275096489 | Eric Taejun Kim | Student in an Organized Health Care Education/Training Program | 184 South Mayo Trail, Pikeville, KY 41501 | 2019-04-13 |
| 1245755206 | Paula Renee Belcher | Nurse Practitioner | 5724 E Shelbiana Road, Pikeville, KY 41501 | 2017-08-10 |
| 1174044390 | Jessie C Deffendall | Dentist | 220 Cassidy Blvd, Pikeville, KY 41501 | 2017-06-28 |
| 1942667456 | Crossroads Addiction Recovery Effort, LLC | Family Medicine | 484 Tollage Crk, Pikeville, KY 41501 | 2016-01-28 |
| 1265836183 | Rebecca Leann Roberts | Pharmacist | 259 Bear Rd, Pikeville, KY 41501 | 2014-10-21 |
| 1306253190 | Ginger Webb Aprn | Clinic/Center | 153 Weddington Branch Rd., Pikeville, KY 41501 | 2014-07-14 |
| 1710323894 | Bhg Xxv, LLC | Case Management | 368 South Mayo Trail, Pikeville, KY 41501 | 2013-05-16 |
| 1740624220 | Sunrise Children's Services, Inc. | Foster Care Agency | 123 Weddington Branch Road, Pikeville, KY 41501 | 2013-04-26 |
| Find all providers in zip 41501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174159156 | Jessica Dawn Blackburn | Nurse Practitioner | 138 Audrey Ln, Pikeville, KY 41501-2845 | 2020-03-21 |
| 1477018851 | Bethany Ann Boyd | Nurse Practitioner | 1391 Left Fork of Island Crk, Pikeville, KY 41501-7324 | 2019-02-09 |
| 1639679459 | Gina Michelle Roberts | Nurse Practitioner | 911 Bypass Rd # Clinic10, Pikeville, KY 41501-1689 | 2018-02-19 |
| 1518470699 | Megan Leann Johnson | Nurse Practitioner | 255 Church St Ste 102b, Pikeville, KY 41501-3476 | 2017-11-10 |
| 1710403274 | Kathryn Lynn Johnson | Nurse Practitioner | 101 Tiger Way, Pikeville, KY 41501-6543 | 2017-08-16 |
| 1245755206 | Paula Renee Belcher | Nurse Practitioner | 5724 E Shelbiana Road, Pikeville, KY 41501 | 2017-08-10 |
| 1255881983 | Kelly Ann Hammerbeck | Nurse Practitioner | 110 Laurel Dr, Pikeville, NC 27863-8395 | 2016-10-05 |
| 1326591454 | Kayla Tanyee Perry | Nurse Practitioner | 3625 Main St, Pikeville, TN 37367-5319 | 2016-07-25 |
| 1003299561 | Chrishaunda Lakeish Vick | Nurse Practitioner | 4680 Us-177, Pikeville, NC 27863 | 2015-07-02 |
| 1912233214 | Pikeville Family Healthcare LLC | Nurse Practitioner | 232 Cleveland Ave., Pikeville, TN 37367-0344 | 2009-10-22 |
| Find all providers in PIKEVILLE | ||||
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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.