Mark A Wallingford (NPI# 1205919875, PAC ID# 4587638721) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1205919875 |
| PAC ID by PECOS | 4587638721 |
| Professional Enrollment ID | I20101015000896 |
| Full Name | Mark A Wallingford |
| Organization Legal Name | SOUTHEASTERN PHYSICIAN SERVICES PC |
| Address |
310 S Limestone Lexington KY 40508-3008 |
| Phone Number | 8592267000 |
| Gender | M |
| Medical School | UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 0042307852 |
| Number of Group Practice Members | 242 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180019 | MEADOWVIEW REGIONAL MEDICAL CENTER |
| 180053 | FLEMING COUNTY HOSPITAL |
| 180035 | ST ELIZABETH EDGEWOOD |
| Address | Phone | Organization |
|---|---|---|
| 310 S Limestone, Lexington, KY 40508-3008 | 8592267000 | SOUTHEASTERN PHYSICIAN SERVICES PC |
| 2009 Old Main St, Maysville, KY 41056-8928 | 6067597615 | MAYSVILLE INTERNAL MEDICINE PEDIATRIC ASSOC PSC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | SOUTHEASTERN PHYSICIAN SERVICES PC |
| Physicians | 263 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Faisal A Soliman | Internal Medicine | Southeastern Physician Services PC | 1995 Hwy 51 S, Covington, TN 38019-3635 |
| Tia Camille Joyce | Nurse Practitioner | Southeastern Physician Services PC | 157 Ross Carter Blvd, Duffield, VA 24244-5116 |
| Patrick C Finney | Internal Medicine | Southeastern Physician Services PC | 2501 Kentucky Ave, Paducah, KY 42003-3813 |
| Carol Ann Berger | Nurse Practitioner | Southeastern Physician Services PC | 300 1st Capitol Dr, Saint Charles, MO 63301-2844 |
| William T Rawlinson | Internal Medicine | Southeastern Physician Services PC | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 |
| Mark D Nowell | Emergency Medicine | Southeastern Physician Services PC | 723 Burkesville Rd, Albany, KY 42602-1654 |
| Lavada Smith | Nurse Practitioner | Southeastern Physician Services PC | 894 Leland Ave, Saint Louis, MO 63130-3239 |
| Kevin L Flowers | Family Medicine | Southeastern Physician Services PC | 1100 Brookhaven Rd, Franklin, KY 42134-2746 |
| Peter J Anderson | Internal Medicine | Southeastern Physician Services PC | 989 Medical Park Dr, Maysville, KY 41056-8750 |
| Hunter Stidham | Physician Assistant | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Street Address |
310 S LIMESTONE |
| City | LEXINGTON |
| State | KY |
| Zip | 40508-3008 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jasmine C Howard | Nurse Practitioner | University of Kentucky | 310 S Limestone, Lexington, KY 40508-3008 |
| Hunter Stidham | Physician Assistant | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Khai Chieu Truong | Family Medicine | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Lindsay A Penn | Physician Assistant | University of Kentucky | 310 S Limestone, Lexington, KY 40508-3008 |
| Donald J Johnson | Physician Assistant | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Hilbert L Gabehart | Certified Registered Nurse Anesthetist (crna) | University of Kentucky | 310 S Limestone, Lexington, KY 40508-3008 |
| Benjamin H Thompson | Internal Medicine | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Jaime R Bailey | Family Medicine | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Anthony Wegbo Echendu | Internal Medicine | Southeastern Physician Services PC | 310 S Limestone, Lexington, KY 40508-3008 |
| Corinne J Hook | Nurse Practitioner | University of Kentucky | 310 S Limestone, Lexington, KY 40508-3008 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shanna M Meyers | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Anne Marion Bearse | Clinical Social Worker | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Mary K Stafford | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Brionna V Leahy | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Alisha M Clemons | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Rinskje De Leeuw | Oral Surgery | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Carrie Dolen | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Peytra C Osetinsky | Qualified Audiologist | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Heidi R Beavan | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Paula R Coffman | Nurse Practitioner | University of Kentucky | 740 S Limestone St, Lexington, KY 40508-0001 |
| Find all physicians in zip 40508 | |||
| City | LEXINGTON |
| Zip Code | 40508 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LEXINGTON + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Mark A Wallingford.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.