MR. ERIC R WOOD (NPI# 1013940956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013940956 |
| Entity Type | Individual |
| Full Name | MR. ERIC R WOOD |
| Credential | PA-C |
| Practice Address |
20 Medical Village Dr Ste 254 Edgewood KY 41017 |
| Mailing Address |
Po Box 635283 Cincinnati OH 45263-5283 |
| Practice Telephone | 8593441600 |
| Practice Fax Number | 8593440091 |
| Mailing Telephone | 8593445555 |
| Mailing Fax Number | 8593445552 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1045 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1045 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA1045 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100056850 | 05 | |
| KY | 9500517900 | 05 | |
| RAILROAD MEDICARE | P00424232 | 01 | |
| OH | OH MEDICARE | WOPA24344 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 580 S Loop Rd, Suite 201, Edgewood, KY 410173415 | 8593441600 | 8593440091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1346629441 | Eric Wood | Dentist | 3610 N University Ave Ste 150, Provo, UT 84604-4444 | 2015-05-21 |
| 1518226042 | Eric Kevin Wood Jr. | Dentist | 2475 E 22nd St Ste 320, Cleveland, OH 44115-3209 | 2012-05-03 |
| 1326327248 | Eric D Wood | Physician Assistant | 215 West 125th Street, 2nd Floor, New York, NY 10027 | 2011-08-09 |
| 1942431259 | Eric Kameron Wood | Dentist | 9990 W 26th Ave Suite 100, Lakewood, CO 80215 | 2009-08-04 |
| 1164677076 | Eric J Wood | Naturopath | 1610 Ne 2nd Ct, Fort Lauderdale, FL 33301-3812 | 2008-11-19 |
| 1689168882 | Eric W Wood | Family Medicine | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-06-20 |
| 1871854992 | Eric Wood | Counselor | 1803 Broad Ripple Ave, Indianapolis, IN 46220-2339 | 2012-06-05 |
| 1265647689 | Eric S Wood | Pharmacist | 523 Thain Rd, Lewiston, ID 83501-5530 | 2007-05-10 |
| 1710044391 | Eric R Wood | Registered Nurse | 1801 Martin Luther King Jr Dr, Helena, AR 72342-8998 | 2007-01-02 |
| Street Address |
20 MEDICAL VILLAGE DR STE 254 |
| City | EDGEWOOD |
| State | KY |
| Zip Code | 41017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710982517 | Michael Keith Davenport | Surgery | 20 Medical Village Dr Ste 254, Edgewood, KY 41017-5401 | 2005-06-17 |
| 1356752737 | Zachary Glenn | Surgery | 20 Medical Village Dr Ste 254, Edgewood, KY 41017-5401 | 2014-05-19 |
| 1790750172 | Joseph Michael Guenther Jr. | Surgery | 20 Medical Village Dr Ste 254, Edgewood, KY 41017-5401 | 2006-02-21 |
| 1801888219 | Kevin D Martin | Specialist | 20 Medical Village Dr Ste 254, Edgewood, KY 41017-5401 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811543812 | Emily Crocetti | Physician Assistant | 20 Medical Village Dr Ste 132, Edgewood, KY 41017-5406 | 2019-08-15 |
| 1053528380 | Casey Lynn Doty | Physician Assistant | 20 Medical Village Dr # 254, Edgewood, KY 41017 | 2007-05-17 |
| 1083212344 | Kelly O'brien | Physician Assistant | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2020-10-09 |
| 1255957122 | Lauren Slabaugh | Physician Assistant | 162 Barnwood Dr, Edgewood, KY 41017-2501 | 2020-06-17 |
| 1700422995 | Samuel Jacob Dedden | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2019-11-21 |
| 1700368495 | Brian R Ingram | Physician Assistant | 1851 Old Hwy 66, Edgewood, NM 87015 | 2018-08-30 |
| 1033628268 | Jennifer Teresa Sprague | Physician Assistant | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2017-09-20 |
| 1932624707 | Thomas Slone Wilkinson | Physician Assistant | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2017-08-13 |
| 1215380100 | Madeleine Lansberry | Physician Assistant | 200 Medical Village Dr, Edgewood, KY 41017 | 2016-07-15 |
| 1922463918 | Nicholas Joseph Reist | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2015-12-18 |
| Find all providers in EDGEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.