EDMONTON PRIMARY CARE NURSING GROUP (NPI# 1629240759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629240759 |
| Entity Type | Organization |
| Organization Name | EDMONTON PRIMARY CARE NURSING GROUP |
| Practice Address |
903 West Stockton Street Edmonton KY 42129 |
| Practice Telephone | 2704325782 |
| Practice Fax Number | 2704320001 |
| Mailing Telephone | 2704325782 |
| Mailing Fax Number | 2704320001 |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |
| Authorized Official Name | MR. REX A TUNGATE (CEO, ADMINISTRATOR) |
| Authorized Official Telephone | 2703844753 |
| Is Organization Subpart | Y |
| Parent Organization Name | ADAIR COUNTY HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1854P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7890217800 | 05 |
| Street Address |
903 WEST STOCKTON STREET |
| City | EDMONTON |
| State | KY |
| Zip Code | 42129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437321494 | Adair County Hospital District | Family Medicine | 903 West Stockton Street, Edmonton, KY 42129 | 2008-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194162503 | Barren River District Health Department | Public Health or Welfare | 102 Ralph Edwards Rd, Edmonton, KY 42129 | 2013-05-24 |
| 1114257615 | Laura Dale Miller | Developmental Therapist | 111 Gail Dr, Edmonton, KY 42129 | 2010-01-05 |
| 1861676421 | Metcalfe Health Services, Inc. | Clinic/Center | 770 Industrial Drive, Edmonton, KY 42129 | 2007-12-19 |
| 1639350200 | Barren River District Health Department | Public Health or Welfare | 615 West Stockton Street, Edmonton, KY 42129 | 2007-11-23 |
| 1336329044 | Metcalfe Co. Schools | Local Education Agency (LEA) | 1007 West Stockton Street, Edmonton, KY 42129 | 2007-11-09 |
| 1013058494 | Mikki S Page | Social Worker | 112 Sartin Dr., Edmonton, KY 42129 | 2007-02-09 |
| 1285771295 | Nancy Lee Barrett | Nurse Practitioner | 112 Sartin Dr, Edmonton, KY 42129 | 2007-01-31 |
| 1629148481 | John W Miller | Dentist | 108 Elmore Street, Edmonton, KY 42129 | 2006-11-09 |
| 1932298312 | James Michael Pasley | Counselor | Metcalfe County Service Center, 112 Sartin Dr, Edmonton, KY 42129 | 2006-10-12 |
| 1154433159 | Sharon Wise | Social Worker | 112 Sartin Drive, Edmonton, KY 42129 | 2006-08-31 |
| Find all providers in zip 42129 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720050818 | Angela F Jessie | Nurse Practitioner | 109 Sartin Dr, Edmonton, KY 42129-8170 | 2006-02-03 |
| 1760861272 | Whitney N Barger | Nurse Practitioner | 208 Randolph St, Edmonton, KY 42129-8175 | 2015-05-29 |
| 1386064228 | Ashley Logan | Nurse Practitioner | 1704 W Stockton St, Edmonton, KY 42129-8137 | 2014-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518661 | Kimberly Sue Moore | Nurse Practitioner | 1196 Sardis Rd, Mount Olivet, KY 41064-7580 | 2020-11-02 |
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1053911065 | Ashley Renee Smith | Nurse Practitioner | 8367 Stonelick Rd, Maysville, KY 41056-9432 | 2020-10-28 |
| 1629677117 | Shelby A Rollings | Nurse Practitioner | 100 Clint Hill Blvd, Paducah, KY 42001-6771 | 2020-10-26 |
| 1023618535 | Pamela Nicole Kinney | Nurse Practitioner | 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 | 2020-10-26 |
| 1710586466 | Jamie Rae Ratcliff | Nurse Practitioner | 141 Ky Route 1428, Prestonsburg, KY 41653-1506 | 2020-10-23 |
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1952900870 | Sarah Elizabeth Clark | Nurse Practitioner | 1309 Morning Side Ct, Lexington, KY 40509-2353 | 2020-10-21 |
| 1942809033 | Lauren Elizabeth Tobler | Nurse Practitioner | 32 Burdsall Ave, Fort Mitchell, KY 41017-2802 | 2020-10-20 |
| 1629677745 | Lisa Elaine Coleman | Nurse Practitioner | 2241 Gulfstream Dr, Lexington, KY 40504-3273 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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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.