DR. JOSEPH C PETROCELLI (NPI# 1538162268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538162268 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH C PETROCELLI |
| Credential | MD |
| Practice Address |
910 Wallace Ave Leitchfield KY 42754-2414 |
| Practice Telephone | 2702593035 |
| Mailing Telephone | 2702593035 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2012-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 20679 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM | 000000050793 | 01 |
| KY | PASSPORT ADVANTAGE | 2433736000 | 01 |
| KY | CHAMPUS | 611269278001 | 01 |
| KY | 64206790 | 05 | |
| KY | PASSPORT | 1054879 | 01 |
| Street Address |
910 WALLACE AVE |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-2414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306450 | Karen Michelle Manning | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-11-02 |
| 1104454834 | Grayson County Hospital Foundation Inc | Obstetrics & Gynecology | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2020-03-30 |
| 1649743667 | Concord Company of Tennessee Pllc | Physician Assistant | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2019-01-03 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1265900955 | Callie J Hancock | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-11-12 |
| 1568941987 | Robert Wayne Fuller | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2018-08-07 |
| 1114442324 | Jared Crocker | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2017-08-08 |
| 1518332691 | Eric Powell | Physical Therapist | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2015-12-01 |
| 1427434026 | Robert Holland | Nurse Anesthetist, Certified Registered | 910 Wallace Ave, Leitchfield, KY 42754 | 2015-08-05 |
| 1750766077 | Cheri Molloy | Dietitian, Registered | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2015-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1912486887 | Jeanette Marie Jacobs | Pediatrics | 901 Wallace Ave, Leitchfield, KY 42754 | 2018-08-10 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134566805 | Clinton Joseph Kaufman | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2013-06-04 |
| 1053601682 | Luke Portwood Fife | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2011-04-16 |
| 1750390415 | Steven Edward Thomas | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2006-08-05 |
| 1104829894 | Twin Lakes Medical Foundation, Inc. | Surgery | 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841811866 | Wayne County Surgical Services | Surgery | 1 S Creek Dr Ste 112, Monticello, KY 42633-9472 | 2020-04-30 |
| 1548757859 | Lexington Vein Institute Pllc | Surgery | 3116 Harrodsburg Rd, Lexington, KY 40503-2709 | 2018-04-23 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1639535677 | David Geller, Md, Pllc | Surgery | 3999 Dutchmans Ln Ste 1e, Louisville, KY 40207-4741 | 2016-01-06 |
| 1134501679 | Gustavo Vincent Huerta | Surgery | 1760 Nicholasville Rd Ste 202, Lexington, KY 40503-1472 | 2015-06-21 |
| 1407237563 | Ashleigh Wright | Surgery | 800 Rose St # C-246, Lexington, KY 40536-0293 | 2015-06-15 |
| 1427439561 | Jahan David Miremami | Surgery | 1 Trillium Way Ste 301, Corbin, KY 40701-8426 | 2015-06-15 |
| 1831585199 | Joseph Robert Lewis | Surgery | 2596 Roseville Rd, Glasgow, KY 42141-8460 | 2015-04-13 |
| 1558761734 | Ashland Integrated Medicine Psc | Surgery | 155 W. Central Avenue, Ashland, KY 41101-7364 | 2014-08-26 |
| 1811300817 | Colin Talanda Fath | Surgery | University of Kentucky General Surgery 800 Rose St, Lexington, KY 40536-1009 | 2014-06-06 |
| Find all providers with the same taxonomy | ||||
| City | LEITCHFIELD |
| Zip Code | 42754 |
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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.