WESTERN KY MEDICAL, LLC (NPI# 1619395605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619395605 |
| Entity Type | Organization |
| Organization Name | WESTERN KY MEDICAL, LLC |
| Practice Address |
609 Hammond Plz Hopkinsville KY 42240-4971 |
| Mailing Address |
1317 Route 73 Ste 200 Mount Laurel NJ 08054-2202 |
| Practice Telephone | 2708878333 |
| Mailing Telephone | 8564396111 |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | ROBYN TANIS (EXECUTIVE DIRECTOR PRACTICE MGMT) |
| Authorized Official Telephone | 8565338762 |
| Is Organization Subpart | Y |
| Parent Organization Name | PINNACLE TREATMENT CENTERS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
810381 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | STATE LICNESE | 810381 | 01 |
| Street Address |
609 HAMMOND PLZ |
| City | HOPKINSVILLE |
| State | KY |
| Zip Code | 42240-4971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760034060 | Norvil Williamson | Counselor | 609 Hammond Plz, Hopkinsville, KY 42240-4971 | 2019-07-16 |
| 1760870331 | Ashley Noelle Bidwell | Counselor | 609 Hammond Plz, Hopkinsville, KY 42240-4971 | 2015-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214264 | Joshua Brian Yates | Pharmacist | 320 West 18th Street, Hopkinsville, KY 42240 | 2020-01-10 |
| 1629540950 | John J Tomasic | Nurse Practitioner | Jennie Stuart Medical Center, 320 W 18th Street, Hopkinsville, KY 42240 | 2018-12-27 |
| 1669962866 | Jeri Lynn Richardson | Developmental Therapist | 119 Forbes Dr, Hopkinsville, KY 42240 | 2018-05-14 |
| 1619416039 | Esther Caro | Case Manager/Care Coordinator | 400a Hammond Plz, Hopkinsville, KY 42240 | 2017-02-17 |
| 1780126532 | Jennifer R. Koranyi | Social Worker | 737b North Dr, Hopkinsville, KY 42240 | 2016-11-10 |
| 1043760937 | Inspira Therapy | Speech-Language Pathologist | 1110 South Main Street, Suite B, Hopkinsville, KY 42240 | 2016-10-04 |
| 1689026049 | Judy Greene Dba Greene Physical Therapy Services | Physical Therapist | 1910 South Virginia Ste., Ste. 108, Hopkinsville, KY 42240 | 2016-07-11 |
| 1083094932 | Cornell Memory Center | Clinic/Center | 101 North Drive, Hopkinsville, KY 42240 | 2015-06-05 |
| 1679978746 | Maulik V Patel | Pharmacist | 2713 A Fort Campbell Blvd, Hopkinsville, KY 42240 | 2014-10-30 |
| 1245630896 | Haregewoin Ezezew Baye | Dentist | 300 Cool Water Ct, Hopkinsville, KY 42240 | 2014-09-02 |
| Find all providers in zip 42240 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730691189 | Maysville Medical, LLC | Clinic/Center | 152 E 2nd St, Maysville, KY 41056-1264 | 2017-10-25 |
| 1053823492 | Carroll Counseling, LLC | Clinic/Center | 539a 11th St, Carrollton, KY 41008-1463 | 2017-10-25 |
| 1720590177 | Simpson Treatment, LLC | Clinic/Center | 2714 Nashville Rd, Franklin, KY 42134-7845 | 2017-10-25 |
| 1700310455 | Center for Behavioral Health Kentucky, Inc. | Clinic/Center | 1018 Ival Jame Bvld, Suite C, Richmond, KY 40475 | 2017-04-19 |
| 1871027854 | Center for Behavioral Health Kentucky, Inc. | Clinic/Center | 1402a Browns Ln, Louisville, KY 40207-4609 | 2017-04-17 |
| 1083148076 | Etown Addiction Solutions, LLC | Clinic/Center | 2645 Leitchfield Rd Ste 104, Elizabethtown, KY 42701-8306 | 2017-04-17 |
| 1669905857 | Daviess Treatment Services LLC | Clinic/Center | 3032 Us Highway 60 E, Owensboro, KY 42303-0288 | 2017-04-05 |
| 1063824381 | Georgetown Medical, LLC | Clinic/Center | 105 Eastside Dr, Suites A, B, and C, Georgetown, KY 40324-9797 | 2014-05-21 |
| 1578986345 | Bhg Xxxiv, LLC | Clinic/Center | 967 S. Highway 25 W, Corbin, KY 40701-4543 | 2014-01-29 |
| 1912553959 | Eastern Point of Recovery | Clinic/Center | 253 Hager Br, East Point, KY 41216-8766 | 2019-08-15 |
| Find all providers with the same taxonomy | ||||
| City | HOPKINSVILLE |
| Zip Code | 42240 |
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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.