VANDERBILT INTEGRATED PROVIDERS (NPI# 1255463949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255463949 |
| Entity Type | Organization |
| Organization Name | VANDERBILT INTEGRATED PROVIDERS |
| Other Organization Name | PEDIATRIC ASSOCIATES |
| Practice Address |
1717 High Street Suite 3a Hopkinsville KY 42240 |
| Practice Telephone | 2708858445 |
| Practice Fax Number | 2708869106 |
| Mailing Telephone | 2708858445 |
| Mailing Fax Number | 2708869106 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2013-02-27 |
| Authorized Official Name | MR. CHRIS WESTBROOK (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 6159365187 |
| Is Organization Subpart | Y |
| Parent Organization Name | VANDERBILT INTEGRATED PROVIDERS D.B.A PEDIATRIC ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
3004549 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
3002428 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 78900800 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatric Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982625091 | Vanderbilt Integrated Providers | Nurse Practitioner | 1717 High St, Suite 3a, Hopkinsville, KY 42240-6300 | 2006-07-22 |
| Street Address |
1717 HIGH STREET SUITE 3A |
| City | HOPKINSVILLE |
| State | KY |
| Zip Code | 42240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214264 | Joshua Brian Yates | Pharmacist | 320 West 18th Street, Hopkinsville, KY 42240 | 2020-01-10 |
| 1629540950 | John J Tomasic | Nurse Practitioner | Jennie Stuart Medical Center, 320 W 18th Street, Hopkinsville, KY 42240 | 2018-12-27 |
| 1669962866 | Jeri Lynn Richardson | Developmental Therapist | 119 Forbes Dr, Hopkinsville, KY 42240 | 2018-05-14 |
| 1619416039 | Esther Caro | Case Manager/Care Coordinator | 400a Hammond Plz, Hopkinsville, KY 42240 | 2017-02-17 |
| 1780126532 | Jennifer R. Koranyi | Social Worker | 737b North Dr, Hopkinsville, KY 42240 | 2016-11-10 |
| 1043760937 | Inspira Therapy | Speech-Language Pathologist | 1110 South Main Street, Suite B, Hopkinsville, KY 42240 | 2016-10-04 |
| 1689026049 | Judy Greene Dba Greene Physical Therapy Services | Physical Therapist | 1910 South Virginia Ste., Ste. 108, Hopkinsville, KY 42240 | 2016-07-11 |
| 1083094932 | Cornell Memory Center | Clinic/Center | 101 North Drive, Hopkinsville, KY 42240 | 2015-06-05 |
| 1679978746 | Maulik V Patel | Pharmacist | 2713 A Fort Campbell Blvd, Hopkinsville, KY 42240 | 2014-10-30 |
| 1245630896 | Haregewoin Ezezew Baye | Dentist | 300 Cool Water Ct, Hopkinsville, KY 42240 | 2014-09-02 |
| Find all providers in zip 42240 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578529665 | Sondra U Price | Nurse Practitioner | 1717 High St, Suite 3a, Hopkinsville, KY 42240-6300 | 2006-04-26 |
| 1780641605 | Margaret D Stevens | Nurse Practitioner | 4235 Fort Campbell Blvd, Hopkinsville, KY 42240-9339 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326695255 | Norton Childrens Medical Group, LLC | Nurse Practitioner | 1930 Bishop Ln Ste 101710th, Louisville, KY 40218-1921 | 2019-08-26 |
| 1407402209 | Elleanor Gray | Nurse Practitioner | 411 E Chestnut St Ste 645, Louisville, KY 40202-1713 | 2019-08-16 |
| 1639681992 | Jazmine Gabrielle Yates | Nurse Practitioner | 1330 S Mayo Trl Ste 201, Pikeville, KY 41501-2321 | 2017-10-26 |
| 1003335050 | Kathryn Alexis Perkins | Nurse Practitioner | 1016 Town Dr, Highland Heights, KY 41076-9753 | 2017-09-11 |
| 1386194447 | Morgan Chojnacki | Nurse Practitioner | Kentucky Clinic Pediatric High Bmi Clinic, 740 S. Limestone 2nd Floor Wing D, Lexington, KY 40536 | 2016-10-12 |
| 1811374887 | Hannah Lynn Puntney | Nurse Practitioner | 800 Rose St. Ms 235, Lexington, KY 40536 | 2015-04-29 |
| 1184016685 | Amy Verst | Nurse Practitioner | 1501 Burnley Rd, Scottsville, KY 42164-9693 | 2015-02-20 |
| 1326454448 | Madisonville Pediatrics | Nurse Practitioner | 15 N Harrig St, Madisonville, KY 42431-2123 | 2014-07-09 |
| 1508294000 | Kelly Caroline Nelson | Nurse Practitioner | 740 S Limestone Rm J442, Lexington, KY 40536-0001 | 2013-10-18 |
| 1467789974 | Amanda Faith Dressman | Nurse Practitioner | 1780 Nicholasville Rd Ste 301, Lexington, KY 40503-1413 | 2009-11-05 |
| Find all providers with the same taxonomy | ||||
| City | HOPKINSVILLE |
| Zip Code | 42240 |
Please comment or provide details below to improve the information on VANDERBILT INTEGRATED PROVIDERS.
| 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.