EAGLE CREEK EMERGENCY GROUP, PC (NPI# 1134627557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134627557 |
| Entity Type | Organization |
| Organization Name | EAGLE CREEK EMERGENCY GROUP, PC |
| Practice Address |
301 Tyson Ave Paris TN 38242-4544 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 7316421220 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |
| Authorized Official Name | DR. DERIK K KING (PRESIDENT) |
| Authorized Official Telephone | 8008939698 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
301 TYSON AVE |
| City | PARIS |
| State | TN |
| Zip Code | 38242-4544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497750244 | Henry County Medical Center | General Acute Care Hospital | 301 Tyson Ave, Paris, TN 38242-4544 | 2005-06-17 |
| 1265039556 | Rural Health Pain Management LLC | Anesthesiology | 301 Tyson Ave, Paris, TN 38242-4544 | 2020-10-08 |
| 1932712452 | Donna Luther Coley | Nurse Practitioner | 301 Tyson Ave, Paris, TN 38242-4544 | 2020-08-25 |
| 1790348100 | Henry County Medical Center | Pharmacy | 301 Tyson Ave, Paris, TN 38242-4544 | 2019-04-22 |
| 1386108058 | Angie Lynn Natero | Registered Nurse | 301 Tyson Ave, Paris, TN 38242-4544 | 2019-01-28 |
| 1457843567 | Charles I Okafor | Physician Assistant | 301 Tyson Ave, Paris, TN 38242-4544 | 2018-06-04 |
| 1811416779 | Franklin James Holcomb | Nurse Practitioner | 301 Tyson Ave, Paris, TN 38242-4544 | 2017-09-12 |
| 1245778448 | Paula C Bell | Pharmacist | 301 Tyson Ave, Pharmacy Department, Paris, TN 38242-4544 | 2017-02-08 |
| 1063958718 | Advanced Diagnostic Imaging, PC | Durable Medical Equipment & Medical Supplies | 301 Tyson Ave, Suite 104, Paris, TN 38242-4544 | 2017-01-18 |
| 1316393176 | Henry County Medical Center | Nurse Anesthetist, Certified Registered | 301 Tyson Ave, Paris, TN 38242-4544 | 2016-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396374732 | Renee Michelle Girouard | Physician Assistant | 209 B Tyson Ave, Paris, TN 38242 | 2020-04-07 |
| 1255960134 | Alexander P Patrone | Student in an Organized Health Care Education/Training Program | 302b Tyson Ave, Paris, TN 38242 | 2020-04-03 |
| 1457980302 | Aswathy Krishnakumar | Student in an Organized Health Care Education/Training Program | 302b Tyson Avenue, Paris, TN 38242 | 2020-04-03 |
| 1053824052 | Rocky Mountain Holdings, LLC | Ambulance | 1949 Driggs Road, Paris, TN 38242 | 2017-11-13 |
| 1588199152 | Taylor Wilson | Dentist | 3485 Highway 79 N, Paris, TN 38242 | 2017-04-20 |
| 1215472592 | Elizabeth Lane Mcintosh | Behavioral Analyst | 28 Fieldstone Dr, Paris, TN 38242 | 2016-12-22 |
| 1124574959 | Patty Wilson | Counselor | 2555 E. Wood Street, Paris, TN 38242 | 2016-08-31 |
| 1942601539 | Trustworthy Anesthesia Care | Nurse Anesthetist, Certified Registered | 1010 Green Hill Dr, Paris, TN 38242 | 2014-09-15 |
| 1083963946 | West Tennessee Physical Medicine, Pllc | General Practice | 1024 Mineral Wells Avenue, Paris, TN 38242 | 2012-09-06 |
| 1316242514 | Henry Co. Health Dept. | Skilled Nursing Facility | 803 Joy St., Paris, TN 38242 | 2011-01-19 |
| Find all providers in zip 38242 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558682955 | Sean Crowley | Emergency Medicine | 105 Smith Heights Rd, Paris, TN 38242-8836 | 2010-06-20 |
| 1588890180 | Joseph Orville Hoffman | Emergency Medicine | 380 Levy Rd, Paris, KY 40361-9562 | 2009-06-09 |
| 1295866382 | David Nicholas Tancredi | Emergency Medicine | 1, Rue Laurent Pichat, Paris, ILE-DE-FRANCE 75116 | 2007-03-08 |
| 1376670828 | Robert Allen Biddle | Emergency Medicine | 4888 Lexington Rd, Paris, KY 40361 | 2007-02-28 |
| 1255355541 | Julia M Huber | Emergency Medicine | 9 Linville Dr, Paris, KY 40361-2129 | 2006-07-27 |
| 1710900444 | Patricia Swiney | Emergency Medicine | 2017 Main St Ste 4, Paris, KY 40361-1167 | 2006-07-25 |
| 1922047059 | Bill Scott Portis | Emergency Medicine | 14201 Tyson Ave, Paris, TN 38222 | 2006-06-05 |
| 1124079579 | Daniel A. Davis | Emergency Medicine | 301 Tyson Ave., Henry County Medical Center Emergency Dep, Paris, TN 38242-1030 | 2006-05-12 |
| 1295785004 | Robert C. Stephenson | Emergency Medicine | Henry County Medical Center Emergency Dept., 301 Tyson Ave., Paris, TN 38242-1030 | 2006-05-11 |
| 1104391119 | Paris Emergency Center, LLC | Emergency Medicine | 3055 Ne Loop 286, Paris, TX 75460-3433 | 2018-10-05 |
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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.