| Monticello Medical Associates | |
|
1 S Creek Dr Ste 102 Monticello KY 42633-9472 | |
| (606) 348-3365 | |
| Not Available |
| Full Name | Monticello Medical Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 S Creek Dr Ste 102, Monticello, Kentucky |
| Authorized Official Name and Position | Robert Parmelee (CEO) |
| Authorized Official Contact | 6063483365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monticello Medical Associates 1 S Creek Dr Ste 102 Monticello KY 42633-9472 Ph: (606) 348-3365 | Monticello Medical Associates 1 S Creek Dr Ste 102 Monticello KY 42633-9472 Ph: (606) 348-3365 |
| NPI Number | 1063007672 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 10/24/2024 |
| Medicare PECOS PAC ID | 2062409154 |
|---|---|
| Medicare Enrollment ID | O20040429000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063007672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Sheryl E Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578554978 PECOS PAC ID: 9436192200 Enrollment ID: I20050603000079 |
| Provider Name | Barry White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609879758 PECOS PAC ID: 1850369679 Enrollment ID: I20070328000053 |
| Provider Name | Sarah Leigh Weddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609962083 PECOS PAC ID: 9335227214 Enrollment ID: I20080417000116 |
| Provider Name | Bonnie Stockton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659327591 PECOS PAC ID: 6103953609 Enrollment ID: I20100414000644 |
| Provider Name | Sherrell L Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780675801 PECOS PAC ID: 6103018163 Enrollment ID: I20101008000363 |
| Provider Name | Peter Petrenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770574147 PECOS PAC ID: 0446442446 Enrollment ID: I20101008000783 |
| Provider Name | Yanire Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093705311 PECOS PAC ID: 0941494132 Enrollment ID: I20101102000108 |
| Provider Name | Misty A Cundiff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497178347 PECOS PAC ID: 3971734617 Enrollment ID: I20140324000414 |
| Provider Name | Mark Anthony Roark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518380625 PECOS PAC ID: 2466675699 Enrollment ID: I20140515001631 |
| Provider Name | Carl Don Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861811093 PECOS PAC ID: 7719100684 Enrollment ID: I20140521001723 |
| Provider Name | Jason T Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245403161 PECOS PAC ID: 5698994168 Enrollment ID: I20140915002456 |
| Provider Name | Susan Terri Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134508880 PECOS PAC ID: 0042514523 Enrollment ID: I20160203000977 |
| Provider Name | Matthew Eaton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336494772 PECOS PAC ID: 7315230745 Enrollment ID: I20160722001510 |
| Provider Name | Mary Chambers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124027438 PECOS PAC ID: 9830160100 Enrollment ID: I20170905002380 |
| Provider Name | Sheeba M. Picard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417087966 PECOS PAC ID: 2466770979 Enrollment ID: I20180322001060 |
| Provider Name | Jacob Dudley Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194232207 PECOS PAC ID: 0244594109 Enrollment ID: I20180501002823 |
| Provider Name | Raymond Bennett Speck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063992956 PECOS PAC ID: 2668723776 Enrollment ID: I20180927002877 |
| Provider Name | Stephanie P. Maggard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154719763 PECOS PAC ID: 6204261126 Enrollment ID: I20200122002105 |
| Provider Name | Misty Gail Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619647658 PECOS PAC ID: 9133508724 Enrollment ID: I20220628003088 |
| Provider Name | Pamela R. Hancock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285347112 PECOS PAC ID: 2163883760 Enrollment ID: I20230728003193 |
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Monticello Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 S Creek Dr Ste 102, Monticello, KY 42633 Phone: 606-348-3365 Fax: 606-348-8496 | |
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