PEDIATRIC SPECIALISTS LLC (NPI# 1184789364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184789364 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALISTS LLC |
| Practice Address |
505 Klutey Park Plaza Dr Henderson KY 42420-5224 |
| Practice Telephone | 2708300313 |
| Practice Fax Number | 2708307117 |
| Mailing Telephone | 2708300313 |
| Mailing Fax Number | 2708307117 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. IYAD ALJABI (PRESTIDENT) |
| Authorized Official Telephone | 2708300313 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
27411 | KY | Allopathic & Osteopathic Physicians |
| X | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
27410 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
505 KLUTEY PARK PLAZA DR |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-5224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518908243 | Iyad A Aljabi | Pediatrics | 505 Klutey Park Plaza Dr, Henderson, KY 42420-5224 | 2006-06-10 |
| 1891929840 | Kentucky Homecare of Henderson, LLC | Clinic/Center | 505 Klutey Park Plaza Dr, Suite A, Henderson, KY 42420-5224 | 2009-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437365376 | William George Cvetnic | Pediatrics | 2172 Indigo Creek Ave, Henderson, NV 89012-6116 | 2007-05-15 |
| 1518908243 | Iyad A Aljabi | Pediatrics | 505 Klutey Park Plaza Dr, Henderson, KY 42420-5224 | 2006-06-10 |
| 1225242662 | Kultida Soontarapornchai | Pediatrics | 10001 S Eastern Ave, Suite 310, Henderson, NV 89052-3907 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265996961 | Rebecca Decker | Pediatrics | 571 S Floyd St Ste 342, Louisville, KY 40202-3816 | 2019-01-27 |
| 1265676142 | Hannah Fischer | Pediatrics | 571 South Floyd Strret, Ste 342, Louisville, KY 40202 | 2009-04-23 |
| 1235338849 | Elie Giryes Abu Jawdeh | Pediatrics | University of Kentucky 800 Rose St, Mn150, Lexington, KY 40536-0001 | 2007-07-13 |
| 1013125202 | Mina Hazem Halim Hanna | Pediatrics | 800 Rose St # Ms 471, Lexington, KY 40536-0298 | 2007-05-19 |
| 1730219395 | Saify Abbasi | Pediatrics | 3170 Running Deer Cir, Louisville, KY 40241-6566 | 2007-03-06 |
| 1972693851 | Neonatal Associates | Pediatrics | 601 S Floyd, Ste 804, Louisville, KY 40202 | 2006-10-13 |
| 1457370934 | Eric William Reynolds | Pediatrics | 5706 Bradbe Forest Ln, Fisherville, KY 40023-7715 | 2006-07-18 |
| 1144298316 | Ketan C Mehta | Pediatrics | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2006-03-14 |
| 1427040443 | Scott D Duncan | Pediatrics | 411 E Chestnut St # 2, Louisville, KY 40202-1713 | 2005-08-16 |
| 1124020144 | Peter John Giannone Jr. | Pediatrics | 800 Rose Street Mn 470, Lexington, KY 40536-0001 | 2005-08-10 |
| Find all providers with the same taxonomy | ||||
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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.