COMMONWEALTH OF KENTUCKY (NPI# 1972054443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972054443 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | ESH PHYSICIAN ASSISTANT GROUP |
| Practice Address |
1350 Bull Lea Rd Lexington KY 40511-1247 |
| Practice Telephone | 8592468000 |
| Practice Fax Number | 8592468043 |
| Mailing Telephone | 8592468000 |
| Mailing Fax Number | 8592468043 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | CARRIE RUDZIK (CFO) |
| Authorized Official Telephone | 8592468204 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| ESH Physician Assistant Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686900 | Commonwealth of Kentucky | Skilled Nursing Facility | 100 Veterans Drive, Radcliff, KY 40160 | 2015-08-14 |
| 1245657857 | Commonwealth of Kentucky | Clinic/Center | 2441 Us Highway 27, Somerset, KY 42501 | 2014-03-20 |
| 1730329897 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood, 2441 S. Hwy 27, Somerset, KY 42501 | 2009-03-03 |
| 1588804546 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood Dr, 2441 S. Hwy 27, Somersetq, KY 42501 | 2009-03-03 |
| 1770762833 | Commonwealth of Kentucky | Residential Treatment Facility, Physical Disabilities | 5659 Main St, Thelma, KY 41260-8609 | 2007-10-25 |
| 1396962551 | Commonwealth of Kentucky | Nursing Facility/Intermediate Care Facility | 200 Veterans Dr, Hazard, KY 41701-9484 | 2007-04-19 |
| 1124144456 | Commonwealth of Kentucky | Pharmacy | 2400 Russellville Road, Hopkinsville, KY 42240 | 2007-03-21 |
| 1194862599 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 23524 Dawson Springs Rd, Dawson Springs, KY 42408-9205 | 2007-02-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1689652513 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 210 Meadows Dr, Mt Washington, KY 40047-6013 | 2005-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMONWEALTH OF KENTUCKY - DEPARTMENT FOR LOCAL GOVERNMENT | 1024 Capital Center Dr Ste 340, Frankfort, KY 40601-7514 |
| Street Address |
1350 BULL LEA RD |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40511-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922067677 | Jinny Rae Woodcock | Registered Nurse | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2006-03-21 |
| 1043822810 | Caitlin Crowder | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2020-08-21 |
| 1811508849 | Charley Renee Saleeby | Nurse Practitioner | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2020-08-13 |
| 1841843844 | Katibeth Sharp | Psychologist | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2019-07-18 |
| 1508320078 | Haley Herndon | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2019-01-29 |
| 1730607722 | Thomas J Shaddix | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2017-08-30 |
| 1790200525 | Paige Kelly Juettner | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2017-08-14 |
| 1326599895 | Commonwealth of Kentucky | Nurse Practitioner | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-10-20 |
| 1750831574 | Lauren M Greenman | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-10-04 |
| 1831646264 | Jerry Keith Coleman II | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278915 | Amy H Ward | Counselor | 1382 Bull Lea Road, Lexington, KY 40511 | 2019-01-03 |
| 1295233104 | Coventry Oak Elementary School | Public Health or Welfare | 2441 Huntly Place, Lexington, KY 40511 | 2018-01-25 |
| 1881192789 | The Stables (school) | Public Health or Welfare | 4089 Iron Works Pike, Lexington, KY 40511 | 2018-01-25 |
| 1124526033 | Garrett Morgan Elementary School | Public Health or Welfare | 1150 Passage Mound Way, Lexington, KY 40511 | 2018-01-25 |
| 1760903520 | Taylor Bowman | Optometrist | 2500 Leestown Road, Lexington, KY 40511 | 2017-07-03 |
| 1982134409 | Amy Beth Powers | Counselor | 455 Park Place, Suite 130, Lexington, KY 40511 | 2017-06-18 |
| 1336695196 | Life Navigation Services, LLC | Community/Behavioral Health | 348 Mcconnells Trace #102, Lexington, KY 40511 | 2016-08-31 |
| 1730545989 | Delmetria Cayson Combs | Counselor | 1374 Bull Lea Road, Lexington, KY 40511 | 2016-01-04 |
| 1720456080 | Lisa Higgins | Case Manager/Care Coordinator | 1351 Newtown Pike #5, Bluegrass, Lexington, KY 40511 | 2015-09-03 |
| 1346500766 | Rachel Elaine Clark | Counselor | 1351 Newtown Pike, Bldg 4, Lexington, KY 40511 | 2012-05-18 |
| Find all providers in zip 40511 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306118617 | Lb Health Psc | Physician Assistant | 1904 Nicholasville Rd, Lexington, KY 40503-2025 | 2012-02-01 |
| 1174890172 | Clayton Phillip Gatterdam Iv | Physician Assistant | 3205 Summit Square Suite 100, Lexington, KY 40509 | 2011-11-19 |
| 1134237340 | Rebecca Ward Hogsten | Physician Assistant | 4071 Tates Creek Centre Dr Ste 100, Lexington, KY 40517-3062 | 2006-08-28 |
| 1427003524 | David Wendell Moore | Physician Assistant | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2006-05-24 |
| 1376514760 | Kerri F Stillwell | Physician Assistant | 110 Houston Street, Lexington, VA 24450-0912 | 2006-02-01 |
| 1215914684 | Philip Harold Lafleur | Physician Assistant | 1055 Dove Run Road, Lexington, KY 40502 | 2005-12-28 |
| 1083690317 | Jana Sue Cuddy | Physician Assistant | 1055 Dove Run Rd, Lexington, KY 40502 | 2005-12-19 |
| 1942852157 | Anna Gayle Scott | Physician Assistant | 989 Governors Ln Ste 220, Lexington, KY 40513-1175 | 2019-07-09 |
| 1609333582 | Hannah Leigh Burford | Physician Assistant | 1401 Harrodsburg Rd Ste C305, Lexington, KY 40504-3771 | 2019-02-27 |
| 1881177186 | Sarah Kruyer | Physician Assistant | 250 Hospital Dr, Lexington, NC 27292-6792 | 2018-09-12 |
| Find all providers in LEXINGTON | ||||
Please comment or provide details below to improve the information on COMMONWEALTH OF KENTUCKY.
| 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.