MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES (NPI# 1619200151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619200151 |
| Entity Type | Organization |
| Organization Name | MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES |
| Other Organization Name | PULMONARY & SLEEP SPECIALISTS OF LONDON |
| Practice Address |
1210 W 5th St London KY 40741-2112 |
| Mailing Address |
Po Box 2638 London KY 40743-2638 |
| Practice Telephone | 6068644030 |
| Practice Fax Number | 6068640115 |
| Mailing Telephone | 6063303404 |
| Mailing Fax Number | 6063303100 |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2009-09-17 |
| Authorized Official Name | KANDI R REA (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 6063303404 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARYMOUNT MEDICAL CENTER PHYSICIAN SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pulmonary & Sleep Specialists of London | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710951116 | Marymount Medical Center Physician Services | Clinic/Center | 1001 Saint Joseph Lane, London, KY 40741-8345 | 2006-02-14 |
| 1043501091 | Marymount Medical Center Physician Services | Clinic/Center | 1406 W 5th St, Ste 201, London, KY 40741-1688 | 2011-04-26 |
| 1699072967 | Marymount Medical Center Physician Services | Durable Medical Equipment & Medical Supplies | 160 London Mountain View Dr, London, KY 40741-6601 | 2011-02-22 |
| 1215133988 | Marymount Medical Center Physician Services | Nurse Anesthetist, Certified Registered | 1001 Saint Joseph Ln, London, KY 40741-8345 | 2007-06-21 |
| 1588797401 | Marymount Medical Center Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 803 Meyers Baker Rd, Ste 150, London, KY 40741-3039 | 2007-03-13 |
| Street Address |
1210 W 5TH ST |
| City | LONDON |
| State | KY |
| Zip Code | 40741-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487648200 | The Medical Specialists of Ky, Psc | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2005-09-08 |
| 1164973798 | Randall Mills | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2016-10-19 |
| 1750749065 | Sabrina Lambert | Nurse Practitioner | 1210 W 5th St, London, KY 40741-2112 | 2016-02-01 |
| 1508157223 | Saint Joseph Medical Foundation, Inc | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2011-04-28 |
| 1235429788 | Saint Joseph Medical Foundation, Inc | Nurse Practitioner | 1210 W 5th St, London, KY 40741-2112 | 2011-04-18 |
| 1750698866 | Dana E Campbell | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2010-09-10 |
| 1790916468 | Cristina Cabral Pauig | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-07-29 |
| 1174751259 | Sjl Physician Management Services, Inc. | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2009-06-26 |
| 1710115175 | Sjl Physician Management Services Inc. | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-06-24 |
| 1992948848 | Cumberland Clinic Pllc | Nurse Practitioner | 1210 W 5th St, London, KY 40741-2112 | 2009-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841244 | Emily Anne Simmons | Pharmacist | 1851 West Hwy 192, London, KY 40741 | 2020-11-06 |
| 1871104364 | Jarrod Lee Napier | Optometrist | 103 Chera Lyn Ln, London, KY 40741 | 2020-08-10 |
| 1295378792 | Rebekah Virginia Elaine Cloud | Nurse Practitioner | 1649 Ky- 192 W, London, KY 40741 | 2019-10-28 |
| 1215416581 | Mary Jean Nolan | Nurse Practitioner | 1649 W. Hwy 192, London, KY 40741 | 2018-08-08 |
| 1558849620 | Pinnacle Treatment Centers Ky-1, LLC | Substance Abuse Rehabilitation Facility | 312 Carrera Drive, London, KY 40741 | 2018-08-01 |
| 1710463435 | Pinnacle Treatment Centers Ky-i, LLC | Substance Abuse Rehabilitation Facility | 300 Carrera Drive, London, KY 40741 | 2018-07-16 |
| 1720591076 | Hillary Clark | Nurse Practitioner | 192 London Shopping Ctr Ste 2, London, KY 40741 | 2017-11-08 |
| 1760901979 | Ariel Siler | Counselor | 454 N. Mcwhorter St., Suite 1, London, KY 40741 | 2017-09-19 |
| 1598287161 | Young Smiles,llc | Clinic/Center | 324 Holly Lane, London, KY 40741 | 2017-07-14 |
| 1952727505 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 2645 N Laurel Rd Ste B, London, KY 40741 | 2014-03-06 |
| Find all providers in zip 40741 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1508157223 | Saint Joseph Medical Foundation, Inc | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2011-04-28 |
| 1326016460 | Aqeel H Mandviwala | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700754 | Yasinmd Pllc | Internal Medicine | 13304 Ridgemoor Dr, Prospect, KY 40059-7139 | 2019-09-27 |
| 1689232258 | Methodist Health, Inc. | Internal Medicine | 4604 Us Highway 60 W Ste E, Morganfield, KY 42437-6515 | 2019-05-30 |
| 1841661410 | Sleep Care Specialist of Louisville | Internal Medicine | 250 E Liberty St Ste 902, Louisville, KY 40202-1538 | 2015-10-08 |
| 1780926279 | Inspired Medical Services, LLC | Internal Medicine | 9805 Brownsboro Rd, Suite 101, Louisville, KY 40241-1125 | 2013-03-22 |
| 1902146277 | Ephraim Mcdowell Health Resource, Inc | Internal Medicine | 470 Linden Ave Ste 7, Harrodsburg, KY 40330 | 2013-02-25 |
| 1518275379 | Matthew James Craig | Internal Medicine | 1225 S Broadway Ste 201, Lexington, KY 40504-2701 | 2010-09-15 |
| 1992969604 | William Benjamin Cundiff | Internal Medicine | 110 Layman Ln, Elizabethtown, KY 42701-2523 | 2008-07-11 |
| 1124297361 | Rejmon Dedaj | Internal Medicine | 2609 New Hartford Rd, Owensboro, KY 42303-1316 | 2008-02-21 |
| 1689758799 | Srinivas M Ammisetty | Internal Medicine | 9350 Us Hwy 23 South, Suite 104, Stanville, KY 41659 | 2006-10-25 |
| 1790888683 | Firas A Koura | Internal Medicine | 1138 Lexington Rd Ste 230, Georgetown, KY 40324-9672 | 2006-09-06 |
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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.