STONECREST FAMILY MEDICINE PLLC (NPI# 1659322808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659322808 |
| Entity Type | Organization |
| Organization Name | STONECREST FAMILY MEDICINE PLLC |
| Practice Address |
101 Stonecrest Road Suite 3 Shelbyville KY 40065 |
| Practice Telephone | 5026335565 |
| Practice Fax Number | 5026335154 |
| Mailing Telephone | 5026335565 |
| Mailing Fax Number | 5026335154 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-08-20 |
| Authorized Official Name | RONALD E CREQUE JR. (OWNER) |
| Authorized Official Telephone | 5026335565 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
36516 | KY | Ambulatory Health Care Facilities |
| Street Address |
101 STONECREST ROAD SUITE 3 |
| City | SHELBYVILLE |
| State | KY |
| Zip Code | 40065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770575979 | Paul A Goodlett | Family Medicine | 101 Stonecrest Road, Suite 3, Shelbyville, KY 40065 | 2005-08-16 |
| 1801083746 | Dana C Kuhn | Family Medicine | 101 Stonecrest Road, Suite 3, Shelbyville, KY 40065 | 2007-09-25 |
| 1992715940 | Lauralee C Coleman | Physician Assistant | 101 Stonecrest Road, Suite 3, Shelbyville, KY 40065 | 2006-08-09 |
| 1194717397 | Ron E Creque Jr. | Family Medicine | 101 Stonecrest Road, Suite 3, Shelbyville, KY 40065 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013348242 | Elisa Sykes-brees | Counselor | 250 Alpine Drive, Shelbyville, KY 40065 | 2013-12-13 |
| 1073800512 | Mimi Y. R. Rayburn | Nurse Practitioner | 865 Old Taylorsville Rd, Shelbyville, KY 40065 | 2011-07-05 |
| 1124310677 | Amanda B Dassel | Pharmacist | 1605 Midland Trail, Shelbyville, KY 40065 | 2011-05-03 |
| 1639468812 | Tia M Alton | Pediatrics | 150 Frankfort Rd Ste 101, Shelbyville, KY 40065 | 2011-03-29 |
| 1699073338 | Emily Ann Waits | Dietitian, Registered | 615 11th Street, Shelby County Health Dept., Shelbyville, KY 40065 | 2011-03-04 |
| 1124335401 | Kelli L. Fetter | Occupational Therapist | 1900 Midland Trail, Ste 1 & 2, Shelbyville, KY 40065 | 2010-09-08 |
| 1083939425 | Marilyn Louise Rhoads | Licensed Practical Nurse | 615 Washington Street, Mercy Clinic, Shelbyville, KY 40065 | 2010-03-29 |
| 1154525277 | Dorman Preschool Center | Early Intervention Provider Agency | 719 Burks Branch Road, Shelbyville, KY 40065 | 2007-06-13 |
| 1194946368 | Joanna Sames | Pharmacist | 16 Village Plaza, Shelbyville, KY 40065 | 2007-05-02 |
| 1033298922 | Robyn A Keeling | Dentist | 502 Mount Eden Rd, Shelbyville, KY 40065 | 2006-11-03 |
| Find all providers in zip 40065 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1780177618 | Access Med, Pllc | Clinic/Center | 642 E Lexington Ave, Danville, KY 40422-1719 | 2018-06-14 |
| 1447743760 | Remedy House Calls | Clinic/Center | 37 Christopher Dr, South Shore, KY 41175-9447 | 2018-06-12 |
| 1932611019 | Family Care Professional Limited Liability Company | Clinic/Center | 3190 Irvine Rd., Richmond, KY 40475-4047 | 2017-10-30 |
| Find all providers with the same taxonomy | ||||
| City | SHELBYVILLE |
| Zip Code | 40065 |
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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.