| Wellington Provider Group Pc | |
|
555 Marriott Dr Ste 315 Nashville TN 37214-5088 | |
| (859) 439-0400 | |
| Not Available |
| Full Name | Wellington Provider Group Pc |
|---|---|
| Speciality | General Practice |
| Location | 555 Marriott Dr Ste 315, Nashville, Tennessee |
| Authorized Official Name and Position | Brittany Dennis (BILLING/CREDENTIALING MANAGER) |
| Authorized Official Contact | 9199127181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellington Provider Group Pc 535 Wellington Way Ste 330 Lexington KY 40503-1331 Ph: () - | Wellington Provider Group Pc 555 Marriott Dr Ste 315 Nashville TN 37214-5088 Ph: (859) 439-0400 |
| NPI Number | 1295459493 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 09/30/2022 |
| Medicare PECOS PAC ID | 8123412459 |
|---|---|
| Medicare Enrollment ID | O20221209000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295459493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Chirag Panchal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437654407 PECOS PAC ID: 1951651868 Enrollment ID: I20221209000216 |
| Provider Name | Kyle George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982199519 PECOS PAC ID: 4688909690 Enrollment ID: I20230120000187 |
| Provider Name | Julie Foucher |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912433756 PECOS PAC ID: 8729355326 Enrollment ID: I20230120000495 |
| Provider Name | Jeffrey Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609830918 PECOS PAC ID: 5395789507 Enrollment ID: I20230123000283 |
| Provider Name | Carl Seger |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699957308 PECOS PAC ID: 1951455773 Enrollment ID: I20230123002448 |
| Provider Name | Michael Mallin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730330788 PECOS PAC ID: 8224180989 Enrollment ID: I20230126000496 |
| Provider Name | Michael Stone |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043201262 PECOS PAC ID: 0143275016 Enrollment ID: I20230209000945 |
| Provider Name | Jeremy Stich |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295027126 PECOS PAC ID: 7416133616 Enrollment ID: I20230302000569 |
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