SUNRISE PEDIATRICS PLLC (NPI# 1386817773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386817773 |
| Entity Type | Organization |
| Organization Name | SUNRISE PEDIATRICS PLLC |
| Practice Address |
3602 Cumberland Ave Suite B103 Middlesboro KY 40965-2614 |
| Mailing Address |
Po Box 546 Middlesboro KY 40965-0546 |
| Practice Telephone | 6062486999 |
| Mailing Telephone | 6062486999 |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-05-28 |
| Authorized Official Name | DR. WAEL I GHANIM (OWNER) |
| Authorized Official Telephone | 6062486999 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 38144 | KY | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | SUNRISE PEDIATRICS PLLC | 12 Joy Rd, Middlebury, CT 06762 |
| Street Address |
3602 CUMBERLAND AVE SUITE B103 |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-2614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861506552 | Vicente Yu Kaw Jr. | Internal Medicine | 3602 Cumberland Ave, Arh Professional Building, Middlesboro, KY 40965-2614 | 2006-08-18 |
| 1073050886 | Amy Shelton | Nurse Practitioner | 3602 Cumberland Ave, Ste. B102, Middlesboro, KY 40965-2614 | 2017-01-31 |
| 1962765578 | Appalachian Regional Healthcare, Inc. | Clinic/Center | 3602 Cumberland Ave, Suite 104, Middlesboro, KY 40965-2614 | 2012-06-19 |
| 1386901254 | Christy Johnson | Nurse Practitioner | 3602 Cumberland Ave, Middlesboro, KY 40965-2614 | 2012-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1306185798 | Stallworth Internal Medicine and Pediatrics | Pediatrics | 2010 Cumberland Ave, Middlesboro, KY 40965-2829 | 2013-02-06 |
| 1649522616 | Pediatric Clinic | Pediatrics | 3604 Cumberland Ave, Middlesboro, KY 40965-2614 | 2012-10-15 |
| 1518235563 | Bright Future Primary Care, Inc. | Pediatrics | 3602 West Cumberland Ave., Ste. B-102, Middlesboro, KY 40965 | 2011-12-06 |
| 1568463834 | Mohamad Hakam Alnahhas | Pediatrics | 3602 Cumberland Ave Ste B-102, Middlesboro, KY 40965-2614 | 2005-08-09 |
| 1083118673 | Rachel Andrea Jones-tackett | Pediatrics | 3602 Cumberland Ave Ste B102, Middlesboro, KY 40965-2614 | 2018-03-20 |
| 1124039953 | Deborah L. Gever | Pediatrics | 3600 Cumberland Ave, Middlesboro, KY 40965-2614 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205452836 | Jenna M. Richards Do | Pediatrics | 793 Eastern Byp Ste 110, Richmond, KY 40475-2425 | 2020-06-19 |
| 1598384745 | Breckinridge Health Clinic | Pediatrics | 203b Fairgrounds Rd, Hardinsburg, KY 40143-2585 | 2020-04-08 |
| 1811533433 | Grace Community Health Center, Inc. | Pediatrics | 120 N Commonwealth Ave Ste 123&4, Corbin, KY 40701-6472 | 2019-11-19 |
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1477059657 | Advanced Care Pediatric Centre Pllc | Pediatrics | 1000 E Lexington Ave Ste 31, Danville, KY 40422-1707 | 2018-04-05 |
| 1396268223 | Prasanna Kumar Gangishetti | Pediatrics | 800 Rose St Rm No Mn-118, Lexington, KY 40536 | 2017-07-23 |
| 1154855054 | John Michael Jansen | Pediatrics | 3320 Tates Creek Rd Ste 302, Lexington, KY 40502-3400 | 2017-04-18 |
| 1396286407 | Alvarado Medical Services Pllc | Pediatrics | 25 E Hickman St, Winchester, KY 40391-2448 | 2017-03-09 |
| 1407218589 | Caitlyn Anglin | Pediatrics | University of Kentucky 800 Rose St Rm Mn 118, Lexington, KY 40536-1356 | 2016-03-28 |
| 1982066296 | Jeremy Sites | Pediatrics | 230 S Central Ave, Somerset, KY 42501-2110 | 2016-03-25 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
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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.