| Medical Center Psychiatry | |
|
350 Park St 204 Bowling Green KY 42101-1784 | |
| (270) 843-5103 | |
| (270) 843-5104 |
| Full Name | Medical Center Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 350 Park St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Michele Lawless (EXECUTIVE VICE PRESIDENT / CFO) |
| Authorized Official Contact | 2707451500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Psychiatry Po Box 90010 Bowling Green KY 42102-9010 Ph: (270) 745-1100 | Medical Center Psychiatry 350 Park St 204 Bowling Green KY 42101-1784 Ph: (270) 843-5103 |
| NPI Number | 1184016123 |
|---|---|
| Provider Enumeration Date | 02/27/2015 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Medicare PECOS PAC ID | 7719899947 |
|---|---|
| Medicare Enrollment ID | O20150402002095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184016123 | NPI | - | NPPES |
| 000000928950 | Other | KY | ANTHEM |
| 7100342590 | Medicaid | KY | |
| 7100346960 | Medicaid | KY | |
| 7100342580 | Medicaid | KY | |
| 7100365240 | Medicaid | KY |
| Provider Name | Charu Raghuvanshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427145275 PECOS PAC ID: 9032018874 Enrollment ID: I20031231000291 |
| Provider Name | Shawn P Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609910108 PECOS PAC ID: 2961554308 Enrollment ID: I20090716000362 |
| Provider Name | Joseph G Grau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508868456 PECOS PAC ID: 8426173022 Enrollment ID: I20100920001007 |
| Provider Name | Dawn Garrett-wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033509393 PECOS PAC ID: 6507182250 Enrollment ID: I20150224001721 |
| Provider Name | Kimberly A Link |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063584209 PECOS PAC ID: 5890893135 Enrollment ID: I20150309002612 |
| Provider Name | Melissa J Mathews |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235339151 PECOS PAC ID: 7911201009 Enrollment ID: I20170428001436 |
| Provider Name | Jordan Embry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508239070 PECOS PAC ID: 3274918982 Enrollment ID: I20220916000641 |
| Provider Name | Kate M Spurling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881914448 PECOS PAC ID: 9739211152 Enrollment ID: I20230710000267 |
| Provider Name | Megan Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730401647 PECOS PAC ID: 9335586908 Enrollment ID: I20240326002727 |
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