PADUCAH PRIMARY CARE, P.S.C. (NPI# 1497892103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497892103 |
| Entity Type | Organization |
| Organization Name | PADUCAH PRIMARY CARE, P.S.C. |
| Practice Address |
4620 Village Square Dr Paducah KY 42001-7501 |
| Mailing Address |
2601 Kentucky Ave Suite 101 Paducah KY 42003-3817 |
| Practice Telephone | 2704428575 |
| Practice Fax Number | 2704428783 |
| Mailing Telephone | 2704428575 |
| Mailing Fax Number | 2704428783 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | DR. RONALD L WILSON (PRESIDENT) |
| Authorized Official Telephone | 2704428575 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65927717 | 05 |
| Street Address |
4620 VILLAGE SQUARE DR |
| City | PADUCAH |
| State | KY |
| Zip Code | 42001-7501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811512957 | Kelsey Brooks Powell | Dentist | 467 Jordan Drive, Suite A, Paducah, KY 42001 | 2020-06-15 |
| 1689236473 | Heath Bryan Coleman Dds of Kentucky Pllc | Dentist | 467 Jordan Dr, Ste 105, Paducah, KY 42001 | 2019-07-02 |
| 1477079333 | Ellen Louise Erwin | Speech-Language Pathologist | 5050b Village Square Drive, Paducah, KY 42001 | 2017-08-22 |
| 1225571391 | Jackie Powers | Counselor | 725 Broadway, Paducah, KY 42001 | 2016-11-22 |
| 1730544388 | Jackie Doublin | Counselor | 4625 Falconcrest Dr., Suite A, Paducah, KY 42001 | 2015-12-28 |
| 1861876997 | Adio Chiropractic Inc | Chiropractor | 2405 Lone Oak Rd, Suite B, Paducah, KY 42001 | 2015-07-18 |
| 1134530546 | Katherine Williamson | Obstetrics & Gynecology | 3927 Primrose Place, Paducah, KY 42001 | 2014-05-20 |
| 1679991061 | Kimberly Faith Wiggins | Social Worker | 425 Broadawy, Paducah, KY 42001 | 2014-04-02 |
| 1013251131 | Rxk Pharmacy | Pharmacy | 3526 Park Plaza Road, Paducah, KY 42001 | 2012-11-15 |
| 1134480098 | William Devin Hinson | Chiropractor | 2405 Lone Oak Road, Suite B, Paducah, KY 42001 | 2012-06-06 |
| Find all providers in zip 42001 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912024563 | Christopher Raymond Phillips | Internal Medicine | 100 Kiana Court, Suite B, Paducah, KY 42001-6787 | 2007-03-26 |
| 1508935446 | Allen Lee Tinsley | Internal Medicine | 4625a Falconcrest Drive, Paducah, KY 42001-7458 | 2006-11-07 |
| 1326078064 | Transformation Wellness Center LLC | Internal Medicine | 632 Lone Oak Rd, Paducah, KY 42003-4540 | 2006-07-04 |
| 1376511063 | Ronald L Wilson | Internal Medicine | 4620 Village Square Drive, Suite 101, Paducah, KY 42001-7501 | 2006-03-09 |
| 1548256316 | Milagros D Teves-mani | Internal Medicine | 225 Medical Center Dr Ste 201, Paducah, KY 42003 | 2005-09-27 |
| 1659903896 | Doc Marvin LLC | Internal Medicine | 544 Lone Oak Rd, Paducah, KY 42003-4538 | 2020-02-05 |
| 1417401365 | Silversage Physician Services of Kentucky, Pllc | Internal Medicine | 544 Lone Oak Rd, Paducah, KY 42003-4538 | 2016-08-09 |
| 1235511601 | John Eric Fleming | Internal Medicine | 2501 Kentucky Ave, Paducah, KY 42003-3813 | 2015-06-22 |
| 1205218948 | Michael Tetteh Nartey Mensah | Internal Medicine | 1530 Lone Oak Rd, Paducah, KY 42003 | 2015-06-18 |
| 1336563543 | Advanced Internal Medicine Pllc | Internal Medicine | 2605 Kentucky Ave, Suite 402, Paducah, KY 42003-3800 | 2014-02-07 |
| Find all providers in PADUCAH | ||||
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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.