Interventional Pain Specialists Of Bowling Green Plc | |
165 Natchez Trace Ave Suite 205 Bowling Green KY 42103-7940 | |
(270) 393-1912 | |
(270) 393-1913 |
Full Name | Interventional Pain Specialists Of Bowling Green Plc |
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Speciality | Anesthesiology |
Location | 165 Natchez Trace Ave, Bowling Green, Kentucky |
Authorized Official Name and Position | Robert Keith Norman (OWNER/PRESIDENT) |
Authorized Official Contact | 2703931912 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Interventional Pain Specialists Of Bowling Green Plc 165 Natchez Trace Ave Suite 205 Bowling Green KY 42103-7940 Ph: (270) 393-1912 | Interventional Pain Specialists Of Bowling Green Plc 165 Natchez Trace Ave Suite 205 Bowling Green KY 42103-7940 Ph: (270) 393-1912 |
NPI Number | 1033356274 |
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Provider Enumeration Date | 01/09/2009 |
Last Update Date | 07/21/2022 |
Certification Date | 06/24/2022 |
Medicare PECOS PAC ID | 6608931035 |
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Medicare Enrollment ID | O20090218000135 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033356274 | NPI | - | NPPES |
7100097740 | Medicaid | KY | |
7100063360 | Medicaid | KY | |
7100062970 | Other | KY | CRNA GROUP MCD NUMBER |
7100152630 | Medicaid | KY |
Provider Name | Eduardo G De Los Reyes |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1972599660 PECOS PAC ID: 7517956048 Enrollment ID: I20050909000601 |
Provider Name | Rodney Ross Miller |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1326033705 PECOS PAC ID: 4880617372 Enrollment ID: I20080118000454 |
Provider Name | Betty J Alexander |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831354497 PECOS PAC ID: 9931262557 Enrollment ID: I20090108000242 |
Provider Name | Adam K Thomas |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1194028670 PECOS PAC ID: 4385825751 Enrollment ID: I20110218000548 |
Provider Name | Jessica M Stinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477854115 PECOS PAC ID: 1759562788 Enrollment ID: I20110224000375 |
Provider Name | Daniel S Reynolds |
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Provider Type | Practitioner - Pain Management |
Provider Identifiers | NPI Number: 1528100625 PECOS PAC ID: 3971773185 Enrollment ID: I20110825000712 |
Provider Name | Jennifer R Parrott |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275812133 PECOS PAC ID: 1759551666 Enrollment ID: I20110901000648 |
Provider Name | Megan S Estes |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1063798924 PECOS PAC ID: 1355500877 Enrollment ID: I20120301000850 |
Provider Name | Christian A Unick |
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Provider Type | Practitioner - Pain Management |
Provider Identifiers | NPI Number: 1619162104 PECOS PAC ID: 5890959316 Enrollment ID: I20120706000258 |
Provider Name | Jacqueline K Pardue |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588943849 PECOS PAC ID: 5193976967 Enrollment ID: I20121105000382 |
Provider Name | Paula M Devore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013251370 PECOS PAC ID: 9537312764 Enrollment ID: I20130119000012 |
Provider Name | Eric T Vessels |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1033351820 PECOS PAC ID: 3678714425 Enrollment ID: I20130722000128 |
Provider Name | Daniel L. Etheridge |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1043649809 PECOS PAC ID: 5294964532 Enrollment ID: I20140206001291 |
Provider Name | Angela L Gipson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316360159 PECOS PAC ID: 2567693468 Enrollment ID: I20140318000564 |
Provider Name | Amy Lynne Labron |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912335811 PECOS PAC ID: 1153552393 Enrollment ID: I20140428000996 |
Provider Name | Rita K Wilson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558764928 PECOS PAC ID: 9436370673 Enrollment ID: I20141031001259 |
Provider Name | Megan L. Kepley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407253081 PECOS PAC ID: 3870817174 Enrollment ID: I20150114002262 |
Provider Name | Andrea M Broughton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104177005 PECOS PAC ID: 8820312911 Enrollment ID: I20150120002002 |
Provider Name | Torie Autumn Hatton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720482409 PECOS PAC ID: 7416271465 Enrollment ID: I20150121001994 |
Provider Name | Emily Renee Langlois |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922496090 PECOS PAC ID: 2961721394 Enrollment ID: I20150506000249 |
Provider Name | Brittany A Sowders |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033595947 PECOS PAC ID: 1951604933 Enrollment ID: I20160126000523 |
Provider Name | Allison L Hogue |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083056220 PECOS PAC ID: 4981907813 Enrollment ID: I20160126002190 |
Provider Name | Joan Haley Douglas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346793528 PECOS PAC ID: 8628358033 Enrollment ID: I20161130002178 |
Provider Name | John A Gardner |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1770826299 PECOS PAC ID: 2769624253 Enrollment ID: I20180604002673 |
Provider Name | Joel Robertson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619554128 PECOS PAC ID: 6305241159 Enrollment ID: I20210817004109 |
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