ST. ELIZABETH PHYSICIANS MAYSVILLE DIAGNOSTIC CENTER, LLC (NPI# 1659633774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659633774 |
| Entity Type | Organization |
| Organization Name | ST. ELIZABETH PHYSICIANS MAYSVILLE DIAGNOSTIC CENTER, LLC |
| Practice Address |
910 Kenton Station Dr Suite E Maysville KY 41056-9613 |
| Mailing Address |
2300 Chamber Center Dr Suite 200 Lakeside Park KY 41017-1673 |
| Practice Telephone | 6067590073 |
| Practice Fax Number | 6067590075 |
| Mailing Telephone | 8593445555 |
| Mailing Fax Number | 8593445552 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2015-01-13 |
| Authorized Official Name | DR. GLENN LOOMIS (CEO) |
| Authorized Official Telephone | 8593443737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| N | 293D00000X | Physiological Laboratory | Laboratories | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100225970 | 05 |
| Street Address |
910 KENTON STATION DR SUITE E |
| City | MAYSVILLE |
| State | KY |
| Zip Code | 41056-9613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659477180 | Shawn Kathleen Ross | Family Medicine | 910 Kenton Station Dr, Maysville, KY 41056 | 2006-09-15 |
| 1780298075 | Lewis County Primary Care Center, Inc | Pharmacy | 910 Kenton Station Dr, Maysville, KY 41056-9613 | 2020-09-03 |
| 1154871804 | Amanda G Marshall | Nurse Practitioner | 910 Kenton Station Dr, Suite C, Maysville, KY 41056-9613 | 2016-10-06 |
| 1952548026 | Laboratory Corporation of America | Clinical Medical Laboratory | 910 Kenton Station Dr, Maysville, KY 41056-9658 | 2009-01-12 |
| 1952423691 | Maysville Diagnostic Center LLC | Clinic/Center | 910 Kenton Station Dr, Suite E, Maysville, KY 41056-9658 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762895 | Kathryn Haire | Dentist | 507 Market Place Drive, Maysville, KY 41056 | 2020-08-26 |
| 1700380375 | Tina Kinney | Nurse Practitioner | 420 W Martin Luther King Hwy, Maysville, KY 41056 | 2018-03-20 |
| 1760901227 | Judith I Marks | Home Health Aide | 211 Houston Ave, Maysville, KY 41056 | 2017-09-15 |
| 1205292299 | Mari Campbell | Physical Therapy Assistant | 479 Tucker Drive, Maysville, KY 41056 | 2016-01-07 |
| 1548545353 | Fit 'n' Trim, Ltd | Dietary Manager | 901 Us 68, Suite 200, Maysville, KY 41056 | 2011-10-13 |
| 1194962696 | Susan L Mccoy | Occupational Therapist | 300 Wood St. #231, Maysville, KY 41056 | 2009-01-21 |
| 1033321930 | Mason Co Health Dept. | Public Health or Welfare | 130 East Second Street, Maysville, KY 41056 | 2007-05-04 |
| 1477671428 | Brown & Payne Home Medical Inc | Durable Medical Equipment & Medical Supplies | 13 East 2nd Street, Maysville, KY 41056 | 2007-03-27 |
| 1760522296 | Mason County Schools | Local Education Agency (LEA) | 34 East Second and Limestone Streets, Maysville, KY 41056 | 2007-02-07 |
| 1275687337 | Buffalo Trace Childrens Advocacy Center | Voluntary or Charitable | 224 Limestone Street, Maysville, KY 41056 | 2007-01-23 |
| Find all providers in zip 41056 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477150712 | Big Sandy Health Care Inc | Clinic/Center | 194 Beriah Blvd, Salyersville, KY 41465 | 2020-10-08 |
| 1881218121 | Strive Health Ky LLC | Clinic/Center | 4511 Springhill Road, Owensboro, KY 42303 | 2020-06-02 |
| 1346714615 | Good Doctor | Clinic/Center | 9405 Us Highway 235, Stanville, KY 41659-9048 | 2019-01-19 |
| 1083192595 | Carson Black Lung Center of Pineville, Inc. | Clinic/Center | 820 Robert L. Maddon Bypass Third Fl, Pineville, KY 40977-1452 | 2018-08-06 |
| 1730665886 | William Shea | Clinic/Center | 149 Moore Dr, Lexington, KY 40503-2918 | 2018-07-12 |
| 1104317734 | Usimc of West Virginia Medical Corporation | Clinic/Center | 908 W Broadway Fl 8, Louisville, KY 40203 | 2018-05-18 |
| 1245747674 | Phaup Chiropractic Center, LLC | Clinic/Center | 95 Ymca Dr Ste A, Madisonville, KY 42431-9035 | 2018-01-08 |
| 1235644287 | First Care Chiropractic Center Psc | Clinic/Center | 5057 Poplar Level Rd Ste 7, Louisville, KY 40219-1129 | 2017-12-12 |
| 1740717818 | Jones-o'neal Enterprises, Pllc | Clinic/Center | 135 Morgan St, Versailles, KY 40383-1428 | 2017-05-18 |
| 1467993709 | Ky Pt Pllc | Clinic/Center | 5520 Fern Valley Rd Ste 108, Louisville, KY 40228-1088 | 2017-03-20 |
| 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.