Adam Nicholas Peddicord, APRN | |
4135 Dixie Hwy, Elsmere, KY 41018-1815 | |
(513) 834-7063 | |
Not Available |
Full Name | Adam Nicholas Peddicord |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 4135 Dixie Hwy, Elsmere, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629433024 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 3009900 (Kentucky) | Primary |
Entity Name | New Age Vitality Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700251626 PECOS PAC ID: 3476858606 Enrollment ID: O20160225000612 |
Entity Name | Brightview Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659769446 PECOS PAC ID: 9032426044 Enrollment ID: O20210202002412 |
Mailing Address | Practice Location Address |
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Adam Nicholas Peddicord, APRN 615 Elsinore Pl Ste 200, Cincinnati, OH 45202-1457 Ph: (513) 834-7063 | Adam Nicholas Peddicord, APRN 4135 Dixie Hwy, Elsmere, KY 41018-1815 Ph: (513) 834-7063 |
Sondra Blythe, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4135 Dixie Hwy, Elsmere, KY 41018 Phone: 513-834-7063 | |
Jessica Claire Mitchell, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1639 Raintree Ct, Elsmere, KY 41018 Phone: 859-308-7439 | |
Summer Marie Trenkamp, APRN-FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4135 Dixie Hwy, Elsmere, KY 41018 Phone: 513-834-7063 | |
Amy Elizabeth Goodman-brown, MSN, APRN, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4135 Dixie Hwy, Elsmere, KY 41018 Phone: 833-510-4357 | |
Matthew Thomas Davey, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4135 Dixie Hwy, Elsmere, KY 41018 Phone: 833-510-4357 |