Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 21992 Main St, Hyden, Kentucky |
Authorized Official Name and Position | Barry K Martin (OWNER/CEO) |
Authorized Official Contact | 6064391300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 1988 Hazard KY 41702-1988 Ph: (606) 439-1300 | 21992 Main St Hyden KY 41749-8567 Ph: (606) 672-5200 |
NPI Number | 1891841961 |
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Provider Enumeration Date | 01/25/2007 |
Last Update Date | 06/21/2021 |
Medicare PECOS PAC ID | 3971415993 |
---|---|
Medicare Enrollment ID | O20031218000752 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891841961 | NPI | - | NPPES |
7100028160 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Wendy F Hansen |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1427094200 PECOS PAC ID: 8527040138 Enrollment ID: I20040607000085 |
Provider Name | Richard D Gibbs |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1356392724 PECOS PAC ID: 7113997594 Enrollment ID: I20040731000238 |
Provider Name | Christie D Herald |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124093026 PECOS PAC ID: 7618909979 Enrollment ID: I20050907000904 |
Provider Name | Sandra L Krasnopolsky |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730250242 PECOS PAC ID: 7719088905 Enrollment ID: I20070718000073 |
Provider Name | Shannon Herald |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114107307 PECOS PAC ID: 4789768078 Enrollment ID: I20080226000215 |
Provider Name | John P Mcmurry |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1396708764 PECOS PAC ID: 6406740885 Enrollment ID: I20080919000061 |
Provider Name | Cecile C Del Mundo |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1669553749 PECOS PAC ID: 4486721974 Enrollment ID: I20080925000217 |
Provider Name | Sherry Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558535237 PECOS PAC ID: 3173673928 Enrollment ID: I20090616000789 |
Provider Name | Kendall L Bowling |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750535670 PECOS PAC ID: 3375699465 Enrollment ID: I20090915000119 |
Provider Name | James Hall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679888119 PECOS PAC ID: 9537285390 Enrollment ID: I20101122001230 |
Provider Name | Margaret Szabunio |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1245269554 PECOS PAC ID: 9537296447 Enrollment ID: I20110301000112 |
Provider Name | Melissa C Collett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528340932 PECOS PAC ID: 6709058399 Enrollment ID: I20111003000668 |
Provider Name | Marion L Shepherd |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548532401 PECOS PAC ID: 2961661913 Enrollment ID: I20120309000547 |
Provider Name | John I Jones |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396974234 PECOS PAC ID: 7315102878 Enrollment ID: I20120706000541 |
Provider Name | Ramon Thomas |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1417025479 PECOS PAC ID: 6901050749 Enrollment ID: I20130204000270 |
Provider Name | Leslie Deaton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083952188 PECOS PAC ID: 3375797608 Enrollment ID: I20130213000471 |
Provider Name | Molly Orourke |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1497062566 PECOS PAC ID: 7113149584 Enrollment ID: I20141119002060 |
Provider Name | Stephanie Hutchison |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1750544185 PECOS PAC ID: 0840479416 Enrollment ID: I20141208001316 |
Provider Name | Jacqueline M Combs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891178851 PECOS PAC ID: 3173421567 Enrollment ID: I20150819007976 |
Provider Name | Wendi A Owen |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1639480726 PECOS PAC ID: 5496984999 Enrollment ID: I20160901002682 |
Provider Name | Roger Strunk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629513239 PECOS PAC ID: 4789967514 Enrollment ID: I20170201002422 |
Provider Name | Amy P Hurley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205375409 PECOS PAC ID: 4688959935 Enrollment ID: I20170328002939 |
Provider Name | Nanditha George |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1750674883 PECOS PAC ID: 6103138029 Enrollment ID: I20170918003041 |
Provider Name | Sheena S White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679040711 PECOS PAC ID: 0042556151 Enrollment ID: I20190110001943 |
Provider Name | Ashli N Fugate |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427525377 PECOS PAC ID: 0446597942 Enrollment ID: I20190122002117 |
Provider Name | Candida Dixon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104489186 PECOS PAC ID: 2264775022 Enrollment ID: I20190517000650 |
Provider Name | Rhonda K Hughes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053954263 PECOS PAC ID: 9537593801 Enrollment ID: I20191218002821 |
Provider Name | Taneisha N Blair |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1285250654 PECOS PAC ID: 5799104212 Enrollment ID: I20201002001362 |
Provider Name | Deonna Campbell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821664350 PECOS PAC ID: 7911300579 Enrollment ID: I20210721000127 |
Provider Name | Angela Hubbard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164094850 PECOS PAC ID: 9234534710 Enrollment ID: I20210820002627 |
Provider Name | Jordan Scott Burke |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1871081919 PECOS PAC ID: 3274884614 Enrollment ID: I20210826003700 |
Provider Name | Lisa Hall |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083243042 PECOS PAC ID: 3577960475 Enrollment ID: I20210920002585 |
Provider Name | Carol L Slone |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942977665 PECOS PAC ID: 6204233976 Enrollment ID: I20210922002508 |
Provider Name | Amye E Thomas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295406494 PECOS PAC ID: 8729476908 Enrollment ID: I20211020001194 |
Provider Name | Makenzie Brooke Herald |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578224622 PECOS PAC ID: 8426442195 Enrollment ID: I20220222001856 |
Provider Name | Sherri L Griffie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336861756 PECOS PAC ID: 6608252937 Enrollment ID: I20221010002507 |
Provider Name | Lyndci Marie Cornett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134833726 PECOS PAC ID: 6901271899 Enrollment ID: I20230406000792 |
Provider Name | David Pace |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114630746 PECOS PAC ID: 0042675852 Enrollment ID: I20230501001940 |
Provider Name | Alisha Danielle Bolen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265113005 PECOS PAC ID: 4688037500 Enrollment ID: I20230825000310 |
Provider Name | Brooke Helen Maria Benton |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1730744137 PECOS PAC ID: 3779947551 Enrollment ID: I20230912003416 |
Provider Name | Kelsey Lowe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053011551 PECOS PAC ID: 5496120792 Enrollment ID: I20231215002149 |
Provider Name | Deloris Alice Sparkman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184490666 PECOS PAC ID: 1557712247 Enrollment ID: I20240106000681 |
Provider Name | Mary Lez Perry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427744333 PECOS PAC ID: 3173968492 Enrollment ID: I20240227001048 |
Provider Name | Avery Blake Shrum |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497333520 PECOS PAC ID: 0749664373 Enrollment ID: I20240829003082 |