IJAZ MAHMOOD MD PLC (NPI# 1225336852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225336852 |
| Entity Type | Organization |
| Organization Name | IJAZ MAHMOOD MD PLC |
| Practice Address |
1239 Woodland Dr Suite 105 Elizabethtown KY 42701-2770 |
| Mailing Address |
222 E Witherspoon St Suite 2000 Louisville KY 40202-6301 |
| Practice Telephone | 2703004461 |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2014-11-25 |
| Authorized Official Name | DR. IJAZ MAHMOOD (OWNER) |
| Authorized Official Telephone | 2703004461 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QX0200X |
Clinic/Center Specialization: Oncology |
31150 | KY | Ambulatory Health Care Facilities |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
1239 WOODLAND DR SUITE 105 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-2770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609858539 | Ijaz Mahmood | Internal Medicine | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2005-11-16 |
| 1457992570 | Marinda Moore Schneider | Nurse Practitioner | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-09-30 |
| 1780246785 | Jordan Harrison | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-07-01 |
| 1700346665 | Tiffani Romayne Wallace | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2019-03-25 |
| 1881162428 | Kristina Marie Boshart | Behavioral Analyst | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
| 1598233132 | Sandrea L Patterson | Behavior Technician | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2018-11-12 |
| 1164970448 | Heartland Whole Brain Learning-pediatric & Adult Therapy LLC | Developmental Therapist | 1239 Woodland Dr, Elizabethtown, KY 42701-2770 | 2016-09-15 |
| 1922443480 | Etown Family Practice Plc | Clinic/Center | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2013-05-09 |
| 1114263100 | Wisdom Key Behavioral Health Services Inc | Nurse Practitioner | 1239 Woodland Dr, Suite 110, Elizabethtown, KY 42701-2770 | 2012-12-18 |
| 1609154442 | Ernest Lee Towns | Counselor | 1239 Woodland Dr, Suite 116, Elizabethtown, KY 42701-2770 | 2011-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225576523 | Rafiq U Rahman Md Psc | Internal Medicine | 101 Financial Pl Ste B103, Elizabethtown, KY 42701-8450 | 2017-02-07 |
| 1730447814 | Natalie W. Harper | Internal Medicine | 521 Robinbrooke Blvd, Elizabethtown, KY 42701-5904 | 2012-04-26 |
| 1316959968 | Vaseem Moulana | Internal Medicine | 1240 Woodland Dr, Elizabethtown, KY 42701-2767 | 2006-08-12 |
| 1033123195 | Stephen R. Toothaker | Internal Medicine | 521 Robinbrooke Blvd Unit 106, Elizabethtown, KY 42701-5946 | 2006-07-27 |
| 1972585883 | Yusuf Khan Deshmukh | Internal Medicine | 1107 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2789 | 2005-11-16 |
| 1609858539 | Ijaz Mahmood | Internal Medicine | 1239 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2770 | 2005-11-16 |
| 1053881896 | Nicholas Alexander Beam | Internal Medicine | 1 Continental Dr, Elizabethtown, PA 17022 | 2018-12-04 |
| 1194923904 | Dr Corzaon A Veza | Internal Medicine | 1118 Woodland Dr, Elizabethtown, KY 42701 | 2007-07-03 |
| 1750494464 | Vaseem Moulana | Internal Medicine | 1240 Woodland Dr, Elizabethtown, KY 42701-2767 | 2006-08-16 |
| 1598747099 | Rafiq U Rahman | Internal Medicine | 1107 Woodland Dr, Suite 105, Elizabethtown, KY 42701-2789 | 2005-11-18 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
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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.