TWIN LAKES MEDICAL FOUNDATION INC (NPI# 1205870862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205870862 |
| Entity Type | Organization |
| Organization Name | TWIN LAKES MEDICAL FOUNDATION INC |
| Practice Address |
908 Wallace Ave Leitchfield KY 42754-1479 |
| Practice Telephone | 2702591626 |
| Practice Fax Number | 2702599582 |
| Mailing Telephone | 2702591626 |
| Mailing Fax Number | 2702599582 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | DENEACE CLEMONS (COO) |
| Authorized Official Telephone | 2702591626 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65937930 | 05 | |
| KY | 7100118990 | 05 | |
| KY | 7100124530 | 05 | |
| KY | 65923997 | 05 | |
| KY | 7100011670 | 05 | |
| KY | 65943045 | 05 | |
| KY | 70900162 | 05 | |
| KY | 7100566530 | 05 | |
| KY | 78903556 | 05 | |
| KY | 65937047 | 05 | |
| KY | 7100072530 | 05 | |
| KY | 7100086880 | 05 | |
| KY | 65939019 | 05 | |
| KY | 7100161750 | 05 | |
| KY | 7100630070 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1895 Elizabethtown Rd, Leitchfield, KY 427549138 | 2702300182 | 2702300014 |
| 207 Fairgrounds Rd, Hardinsburg, KY 401432585 | 2702300124 | 2702300157 |
| 910 Wallace Ave, Leitchfield, KY 427542414 | 2702592700 | 2702592717 |
| 912 Wallace Ave, Leitchfield, KY 427542404 | 2702599316 | 2702596571 |
| 301 Sunset Dr, Caneyville, KY 427219172 | 2708793711 | 2708798674 |
| 9847 Elizabethtown Rd, Big Clifty, KY 427125880 | 2702422000 | 2702422100 |
| 1003 N Dixie Ave, Elizabethtown, KY 427012521 | 2702300212 | 2702300104 |
| 1573 Ky Highway 259 N, Brownsville, KY 422108936 | 2702593035 | 2702593332 |
| 1911 Campbellsville Rd, Greensburg, KY 427437758 | 2702300212 | 2702300104 |
| Street Address |
908 WALLACE AVE |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1598311045 | Ashley Nicole Flener | Nurse Practitioner | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2019-08-12 |
| 1700307451 | Jennifer Hughes | Nurse Practitioner | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2017-07-03 |
| 1578971800 | Bryce A. Meredith | Family Medicine | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2014-07-30 |
| 1366869208 | Elizabeth S Stivers | Pediatrics | 908 Wallace Ave, Suite 108, Leitchfield, KY 42754-1479 | 2014-03-27 |
| 1134488539 | Isaac David Miller | Family Medicine | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2012-05-07 |
| 1255526307 | Tony W Lee Do Medical Offices, Pllc | Internal Medicine | 908 Wallace Ave, Suite 203, Leitchfield, KY 42754-1479 | 2007-09-12 |
| 1689727398 | Robert Carroll Goodman Jr. | Pharmacist | 908 Wallace Ave, Suite 105, Midway Pharmacy, Leitchfield, KY 42754-1479 | 2007-01-18 |
| 1518042886 | Shagufta Yousaf | Pediatrics | 908 Wallace Ave, Ste 108, Leitchfield, KY 42754 | 2006-10-26 |
| 1982682878 | Trevor Vance Ray | Pharmacist | 908 Wallace Ave, Suite 105, Leitchfield, KY 42754-1479 | 2006-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1912486887 | Jeanette Marie Jacobs | Pediatrics | 901 Wallace Ave, Leitchfield, KY 42754 | 2018-08-10 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639402316 | Jenna Bratcher | Nurse Practitioner | 133 Fountain View Drive, Leitchfield, KY 42754-1318 | 2009-09-11 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1700395654 | Ack Healthcare Management LLC | Nurse Practitioner | 312 N Main St, Leitchfield, KY 42754 | 2017-09-22 |
| 1518224336 | Kirsten Sizemore | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2012-04-18 |
| 1295052975 | Twin Lakes Medical Foundation, Inc. | Nurse Practitioner | 912 Wallace Ave, Leitchfield, KY 42754-2404 | 2010-04-21 |
| 1285866301 | Debra S Lusk | Nurse Practitioner | 910 Wallace Ave, Suite 207, Leitchfield, KY 42754-2414 | 2009-08-24 |
| 1902982002 | Twin Lakes Medical Foundation, Inc. | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2006-10-31 |
| 1811964091 | Noye Rowgena Cain | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891645 | K Tierney Lanham LLC | Nurse Practitioner | 6431 Regency Ln, Louisville, KY 40207-2309 | 2020-11-06 |
| 1922608827 | Heidi Denise Estes | Nurse Practitioner | 651 U.S. 31 W Bypass Ste 106, Bowling Green, KY 42101 | 2020-10-29 |
| 1124626700 | Mind & Body Wellness | Nurse Practitioner | 105 Bob White Path, Georgetown, KY 40324-6169 | 2020-10-15 |
| 1902404759 | Cassie Parr | Nurse Practitioner | 57 Melissa Branch Rd, Ary, KY 41712-8716 | 2020-10-14 |
| 1649877275 | Kristy Faith Statzer | Nurse Practitioner | 7533 Russellville Rd, Morgantown, KY 42261-9625 | 2020-10-06 |
| 1124635446 | Tori Crabtree | Nurse Practitioner | 1511 Valley Dr, Flatwoods, KY 41139-1889 | 2020-09-30 |
| 1518574235 | Margaret E Lambert | Nurse Practitioner | 2241 Abbeywood Rd, Lexington, KY 40515-1157 | 2020-09-27 |
| 1003422270 | Victoria Weis | Nurse Practitioner | 9301 Dayflower St Ste 100, Prospect, KY 40059-7585 | 2020-09-22 |
| 1598370694 | Candace Jones-martin | Nurse Practitioner | 111 Osbourne Way # 101, Georgetown, KY 40324-8004 | 2020-09-15 |
| 1588274161 | Karyn Michele Bentley | Nurse Practitioner | 210 Hoagland Hill Rd, Mount Washington, KY 40047-7583 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
| City | LEITCHFIELD |
| Zip Code | 42754 |
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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.