DR. JERRY JOSEPH LIERL (NPI# 1679541163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679541163 |
| Entity Type | Individual |
| Full Name | DR. JERRY JOSEPH LIERL |
| Credential | M.D. |
| Practice Address |
20 Medical Village Dr Ste. 177 Edgewood KY 41017-5401 |
| Mailing Address |
20 Medical Village Dr Ste 177 Edgewood KY 41017-5401 |
| Practice Telephone | 8593313353 |
| Practice Fax Number | 8593313326 |
| Mailing Telephone | 8593313353 |
| Mailing Fax Number | 8593313326 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2011-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35050795 | OH | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
20196 | KY | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35050795 | OH | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
20196 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64201965 | 05 | |
| KY | RAILROAD MEDICARE | P00912930 | 01 |
| OH | 0626951 | 05 |
| Street Address |
20 MEDICAL VILLAGE DR STE. 177 |
| City | EDGEWOOD |
| State | KY |
| Zip Code | 41017-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295243 | Paul Allen Jacobs | Obstetrics & Gynecology | 20 Medical Village Dr, Ste 302, Edgewood, KY 41017-5402 | 2005-06-14 |
| 1043821085 | David Thomas Tackett | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-08-13 |
| 1245866888 | Annalee Fitzpatrick | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-03-16 |
| 1972137313 | Thomas Gravely | Pharmacist | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2020-02-25 |
| 1205487071 | Amanda M Hofmeyer | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2019-09-24 |
| 1528535804 | Heidi Ann Ducker | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2018-10-25 |
| 1316433014 | Tara Nagaraj | Pharmacist | 20 Medical Village Dr, Edgewood, KY 41017 | 2018-07-05 |
| 1033628268 | Jennifer Teresa Sprague | Physician Assistant | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2017-09-20 |
| 1235658857 | Eric Joseph Faris | Nurse Practitioner | 20 Medical Village Dr, Edgewood, KY 41017 | 2017-09-14 |
| 1356876940 | Jennifer Vaden | Registered Nurse | 20 Medical Village Dr, Suite 301, Edgewood, KY 41017-5401 | 2017-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1275536302 | Jerome B Schutzman | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2005-05-23 |
| 1407045693 | Hareeprasad Reddy Vongooru | Internal Medicine | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2007-10-24 |
| 1093905663 | Comprehensive Cardiology Consultants, Inc | Internal Medicine | 1 Medical Village Dr, Heart Failure Clinic, Edgewood, KY 41017-3403 | 2007-07-30 |
| 1265642193 | Saadeddine Dughman | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2007-05-22 |
| 1538108881 | Deepthi R Mosali | Internal Medicine | 1 Medical Village Drive, Edgewood, KY 41017 | 2006-06-05 |
| 1871545004 | Patient Choice Cardiology, P.s.c. | Internal Medicine | 20 Medical Village Dr, Ste. 177, Edgewood, KY 41017-5401 | 2006-05-16 |
| 1881646339 | Jon Christian Hays | Internal Medicine | 20 Medical Village Dr, Ste 177, Edgewood, KY 41017 | 2006-05-16 |
| 1417934415 | Cardiology Associates, Psc | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2005-12-30 |
| 1679576771 | Darryl D Dias | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2005-05-23 |
| 1922002252 | Mark K Jordan | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2005-05-23 |
| Find all providers in EDGEWOOD | ||||
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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.