Jenna Leigh Dismore Wrinkles, MD | |
1107 Crown Pointe Dr Ste 107, Elizabethtown, KY 42701-7280 | |
(270) 506-3300 | |
(270) 506-2843 |
Full Name | Jenna Leigh Dismore Wrinkles |
---|---|
Gender | Female |
Speciality | Pain Management |
Experience | 14 Years |
Location | 1107 Crown Pointe Dr Ste 107, Elizabethtown, Kentucky |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780909952 | NPI | - | NPPES |
P01957674 | Other | IN | RAILROAD MEDICARE |
1232438 | Other | KY | WELLCARE OF KY PROVIDER ID NUMBER |
201317930 | Medicaid | IN | |
P01590218 | Other | KY | RAILROAD MEDICARE |
5661958 | Other | AETNA PIN | |
CS1612000141 | Other | CARESOURCE ID | |
005625439 | Other | UNITED HEALTHCARE PROVIDER ID NUMBER | |
000000963791 | Other | ANTHEM PIN | |
339847KYIP | Other | KY | AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER |
2355628 | Other | CIGNA PROVIDER ID NUMBER | |
7100167720 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207LP2900X | Anesthesiology - Pain Medicine | 01075865A (Indiana) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | 47108 (Kentucky) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Hardin Memorial Hospital | Elizabethtown, KY | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Commonwealth Pain Associates Pllc | 0941441919 | 112 |
Commonwealth Pain Associates Pllc | 0941441919 | 112 |
Entity Name | Commonwealth Pain Associates Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306280177 PECOS PAC ID: 0941441919 Enrollment ID: O20130802000577 |
Mailing Address | Practice Location Address |
---|---|
Jenna Leigh Dismore Wrinkles, MD Po Box 21890, Belfast, ME 04915-4115 Ph: (502) 907-0356 | Jenna Leigh Dismore Wrinkles, MD 1107 Crown Pointe Dr Ste 107, Elizabethtown, KY 42701-7280 Ph: (270) 506-3300 |
Aaron E Medley, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 639 North Mulberry, Heartland Anesthesia Consultants Psc, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 | |
Daniel Kuo, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 3170 Hutcherson Ln, Elizabethtown, KY 42701 Phone: 270-765-4275 | |
Vicente Gavieres, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 639 N Mulberry St, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 | |
Benjamin Martinez, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 639 N Mulberry St, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 | |
Polly Foreman, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 639 N Mulberry St, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 | |
Robert A Stein Jr., MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 639 N Mulberry St, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 | |
David Bower, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 639 N Mulberry St, Elizabethtown, KY 42701 Phone: 270-737-4600 Fax: 270-737-1722 |