HEART SPECIALISTS OF SE KY PSC (NPI# 1386752756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386752756 |
| Entity Type | Organization |
| Organization Name | HEART SPECIALISTS OF SE KY PSC |
| Other Organization Name | HEART SPECIALISTS OF SE KY PSC |
| Practice Address |
45 Moonbow Plz Corbin KY 40701-8949 |
| Practice Telephone | 6065239010 |
| Practice Fax Number | 6065235923 |
| Mailing Telephone | 6065239010 |
| Mailing Fax Number | 6065235923 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | JANIE RENEE OKUMA (OFFICE MANAGER) |
| Authorized Official Telephone | 6065239010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA249 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 4069P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 174400000X | Specialist | 29557 | KY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65914996 | 05 |
| Other Name | Type Code |
|---|---|
| HEART SPECIALISTS OF SE KY PSC | Doing Business As Name - Organization |
| Street Address |
45 MOONBOW PLZ |
| City | CORBIN |
| State | KY |
| Zip Code | 40701-8949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417996 | Pramod A Reddy | Internal Medicine | 45 Moonbow Plz, Corbin, KY 40701-8949 | 2005-06-16 |
| 1265904890 | Charity Douglas | Nurse Practitioner | 45 Moonbow Plz, Corbin, KY 40701-8949 | 2018-12-20 |
| 1578052973 | Devin Lee Michael Edwards | Physician Assistant | 45 Moonbow Plz, Corbin, KY 40701 | 2018-05-02 |
| 1033546296 | Amanda Kathryn Hammons | Physician Assistant | 45 Moonbow Plz, Corbin, KY 40701-8949 | 2013-10-02 |
| 1689767543 | Khaled Saleh | Specialist | 45 Moonbow Plz, Corbin, KY 40701 | 2006-10-02 |
| 1043222029 | John P. Loventhal | Internal Medicine | 45 Moonbow Plz, Corbin, KY 40701-8949 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1376014183 | Ruth Ann Thornhill | Nurse Practitioner | 521 E. Cumberland Gap Parkway #1, Corbin, KY 40701 | 2018-12-06 |
| 1770066136 | Grace Community Health Center, Inc. | Psychologist | 50 Ed Mcneel Drive, Corbin, KY 40701 | 2018-09-12 |
| 1235610353 | Linda Bales | Occupational Therapist | 112 Commonwealth Avenue, Corbin, KY 40701 | 2018-08-27 |
| 1710465398 | Holly Davina Bingham | Counselor | 1203 Amercn Grtg Card Rd, Corbin, KY 40701 | 2018-08-05 |
| 1881134914 | Angie Mossie Ledford | Nurse Practitioner | 521 Cumberland Gap Parkway #1, Corbin, KY 40701 | 2017-03-08 |
| 1669915609 | Energized Therapy | Occupational Therapist | 702 Phillips Lane, Corbin, KY 40701 | 2016-11-23 |
| 1649635293 | Debra Ann Hipsher | Counselor | 967 South Hwy 25 West, Corbin, KY 40701 | 2015-12-28 |
| 1356729438 | Sean William James | Family Medicine | 14949 N Us Highway 25 E Ste 4, Corbin, KY 40701 | 2015-05-11 |
| 1962847285 | Angela Davidson Gabbard | Dentist | 129 S. Hwy 1223, Corbin, KY 40701 | 2013-04-30 |
| Find all providers in zip 40701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851703599 | Lisa Ann Maynes | Specialist | 348 S Highway 1223, Corbin, KY 40701-4643 | 2014-05-29 |
| 1407180953 | Annette L. Goodin | Specialist | 212 Brandon Dr, Corbin, KY 40701-4253 | 2009-09-30 |
| 1588870489 | Susanne Potter | Specialist | 441 Hwy 2417, Corbin, KY 40701 | 2007-05-15 |
| 1720110182 | Manoochehr Mazloomdoost Psc | Specialist | 103 Greer Lane, Corbin, KY 40701 | 2007-03-12 |
| 1457386609 | Larry Edward Taylor | Specialist | 1705 Forest Dr, Corbin, KY 40701-2354 | 2006-07-12 |
| 1063416741 | David Edward Muffly | Specialist | 1490 Cumberland Falls Hwy, Corbin, KY 40701-2721 | 2005-06-09 |
| 1760656797 | Allergy Associates, P.a. | Specialist | 1317 Cumberland Falls Hwy, Suite A, Corbin, KY 40701-2720 | 2008-04-22 |
| 1265638076 | Women's Wellness Center of Corbin, Pllc | Specialist | 1705 Forest Dr, Corbin, KY 40701-2354 | 2007-06-27 |
| 1760600126 | Kevin J Croce | Specialist | 1 Trillium Way, Corbin, KY 40701-8727 | 2007-04-23 |
| 1700928140 | Melissa L F Knuckles Md Psc | Specialist | 1101 East Master Street, Corbin, KY 40701-3511 | 2007-02-13 |
| Find all providers in CORBIN | ||||
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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.