RENITA L. CROUCH (NPI# 1437243938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437243938 |
| Entity Type | Individual |
| Full Name | RENITA L. CROUCH |
| Credential | P.A.-C. |
| Practice Address |
Uk Surgery Clinic - Cardiothoracic 740 S Limestone Ste L304 Lexington KY 40536 |
| Mailing Address |
100 North Eagle Creek Drive Lexington KY 40509 |
| Practice Telephone | 8593236494 |
| Mailing Telephone | 8592585300 |
| Mailing Fax Number | 8592585357 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA096 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA096 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA096 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICAID LAB GROUP | 37903705 | 01 |
| KY | 95002556 | 05 | |
| GA | RR MEDICARE PIN | 970025767 | 01 |
| KY | MEDICARE LAB GROUP | 4000501 | 01 |
| GA | RR MEDICARE GROUP | CB5773 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 North Eagle Creek Drive, Lexington, KY 40509 | 8592585300 | 8592585357 |
| Street Address |
UK SURGERY CLINIC - CARDIOTHORACIC 740 S LIMESTONE STE L304 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538502265 | Clinton Travis Morgan | Surgery | Uk Surgery Clinic - Cardiothoracic, 740 S Limestone Ste L304, Lexington, KY 40536-0284 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790394583 | Mary Luz Calderon | Physician Assistant | Uk Pediatric Neonatology, 800 Rose St 4th Fl, Lexington, KY 40536 | 2020-07-28 |
| 1598389421 | Storm Bryant Dutton | Physician Assistant | Uk Emergency Department - Chandler, 1000 S Limestone, Lexington, KY 40536 | 2020-06-06 |
| 1720601545 | Tyler Allen Pape | Physician Assistant | Uk Surgery Clinic - General, 740 S Limestone Ste L104, Lexington, KY 40536 | 2020-05-27 |
| 1417579269 | Kacy Clinkenbeard | Physician Assistant | Uk Healthcare-icu, 800 Rose St, Lexington, KY 40536 | 2020-05-15 |
| 1023578804 | William Chalmers Ruffin | Student in an Organized Health Care Education/Training Program | 740 South Limestone St. E300e, Lexington, KY 40536 | 2019-03-20 |
| 1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
| 1982109708 | Khader Samir Habash | Dentist | 740 S Limestone Room A262, Lexington, KY 40536 | 2018-03-25 |
| 1609370683 | Casey Michael Fitzgerald | Otolaryngology | 740 South Limestone Ears Nose and Throat Clinic, Lexington, KY 40536 | 2018-03-22 |
| 1538663992 | Heather Oaks | Nurse Practitioner | Uk Gill Heart Institute 800 Rose St, Lexington, KY 40536 | 2018-03-21 |
| 1396268223 | Prasanna Kumar Gangishetti | Pediatrics | 800 Rose St Rm No Mn-118, Lexington, KY 40536 | 2017-07-23 |
| Find all providers in zip 40536 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282095 | Alison Deanne Power | Physician Assistant | 3209 Keithshire Way, Lexington, KY 40503-3481 | 2020-10-09 |
| 1588270110 | Reid Van Bussum | Physician Assistant | 913 Fiddler Creek Way, Lexington, KY 40515-6460 | 2020-09-18 |
| 1790394583 | Mary Luz Calderon | Physician Assistant | Uk Pediatric Neonatology, 800 Rose St 4th Fl, Lexington, KY 40536 | 2020-07-28 |
| 1689283731 | Corine Maria Van Gessel | Physician Assistant | 800 Rose Street Neonatal Intensive Care Unit, Lexington, KY 40536-0001 | 2020-07-24 |
| 1942827183 | Michael Dale Anthony Farran | Physician Assistant | 1401 Harrodsburg Rd Ste C405, Lexington, KY 40504-1748 | 2020-07-04 |
| 1033735204 | Melissa Mccool | Physician Assistant | 525 Red Taffy Way, Lexington, SC 29073-2907 | 2020-06-23 |
| 1598389421 | Storm Bryant Dutton | Physician Assistant | Uk Emergency Department - Chandler, 1000 S Limestone, Lexington, KY 40536 | 2020-06-06 |
| 1265056428 | Bernard L Bell | Physician Assistant | 838 Bryan Ave Apt 2, Lexington, KY 40505-3540 | 2020-06-03 |
| 1720601545 | Tyler Allen Pape | Physician Assistant | Uk Surgery Clinic - General, 740 S Limestone Ste L104, Lexington, KY 40536 | 2020-05-27 |
| 1417579269 | Kacy Clinkenbeard | Physician Assistant | Uk Healthcare-icu, 800 Rose St, Lexington, KY 40536 | 2020-05-15 |
| Find all providers in LEXINGTON | ||||
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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.