COMMUNITY CARE OF KENTUCKY, INC (NPI# 1053799080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053799080 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF KENTUCKY, INC |
| Practice Address |
1175 S Main St Ste 4 Madisonville KY 42431-3337 |
| Mailing Address |
Po Box 2369 Anniston AL 36202-2369 |
| Practice Telephone | 2703835511 |
| Practice Fax Number | 2708219602 |
| Mailing Telephone | 2567417340 |
| Mailing Fax Number | 2567417373 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | JENELL STUMP (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Telephone | 6299995006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100298140 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962880997 | Community Care of Kentucky, Inc | Dentist | 122 S Lee Trover Todd Jr Hwy, Earlington, KY 42410-1557 | 2015-05-11 |
| 1194103127 | Community Care of Kentucky, Inc | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2015-05-11 |
| 1851779888 | Community Care of Kentucky, Inc | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2015-05-11 |
| Street Address |
1175 S MAIN ST STE 4 |
| City | MADISONVILLE |
| State | KY |
| Zip Code | 42431-3337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952822827 | Whitney Deanne James | Dentist | 1175 S Main St Ste 4, Madisonville, KY 42431-3337 | 2017-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750846309 | Sarah Davenport Ziegler | Registered Nurse | 3050 Nebo Rd, Madisonville, KY 42431 | 2019-02-08 |
| 1134604903 | Kelsey Dawn Wilson | Occupational Therapist | 425 Island Ford Rd, Madisonville, KY 42431 | 2018-09-27 |
| 1174006209 | Shaun Vickery | Physical Therapist | 425 Island Ford Road, Madisonville, KY 42431 | 2018-09-14 |
| 1881115384 | Filza Tajik | Speech-Language Pathologist | 1305-1 W. Noel Ave, Unit 1, Madisonville, KY 42431 | 2017-07-05 |
| 1245769280 | Susan Hart | Student in an Organized Health Care Education/Training Program | 200 Clinic Drive, Third North, Madisonville, KY 42431 | 2017-06-05 |
| 1811363880 | Cory Eakins | Nutritionist | 2223 S Main St, Madisonville, KY 42431 | 2015-08-13 |
| 1932598257 | Deidra Boyken | Counselor | 145 E. Center Street Suite 1d, Madisonville, KY 42431 | 2015-01-12 |
| 1841602398 | Jessica France | Occupational Therapist | 339 S Seminary St, Madisonville, KY 42431 | 2014-06-02 |
| 1497097562 | Sunrise Children's Services | Community/Behavioral Health | 1079 Thornberry Dr Ste 203, Madisonville, KY 42431 | 2013-03-26 |
| 1013275023 | Creasha King | Counselor | 1079 Thornberry Dr Ste B, Madisonville, KY 42431 | 2012-04-26 |
| Find all providers in zip 42431 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386801298 | Dr.thomas E. Drake | Dentist | 1519 Highway 22 W, Suite #3, Madisonville, LA 70447-9489 | 2008-05-19 |
| 1881811511 | John Alan Roy | Dentist | 1410 Pride Ave Ste C, Madisonville, KY 42431-9107 | 2007-04-20 |
| 1073632568 | Frank Joseph Ferrara II | Dentist | 301 Covington St., Madisonville, LA 70447 | 2007-03-28 |
| 1366592834 | Charles Bradley Foy Jr. | Dentist | 400 Pine St, Madisonville, LA 70447-9743 | 2007-01-10 |
| 1699856740 | George P. Franco Jr. Dds LLC | Dentist | 377 Hwy 21, Suite 102, Madisonville, LA 70447 | 2006-10-17 |
| 1457463820 | Mac L Bennett IIi Dds Inc | Dentist | 714 B South Madison, Madisonville, TX 77864 | 2006-08-31 |
| 1316955008 | Melinda Eiserloh Hickey | Dentist | 198 Hwy 21, Madisonville, LA 70447 | 2006-08-04 |
| 1255347266 | Laurie Leonard Miller | Dentist | 198 Highway 21, Madisonville, LA 70447-9674 | 2006-07-31 |
| 1407862626 | Randolph Thomas Travis | Dentist | 1400 Pride Avenue, Madisonville, KY 42431-9108 | 2006-07-31 |
| 1124023676 | James M Dash | Dentist | 210 Warren St, Madisonville, TN 37354-1090 | 2005-06-20 |
| Find all providers in MADISONVILLE | ||||
| City | MADISONVILLE |
| Zip Code | 42431 |
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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.