EGAN CLINIC PSC (NPI# 1700150109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700150109 |
| Entity Type | Organization |
| Organization Name | EGAN CLINIC PSC |
| Practice Address |
12945 W Highway 42 Prospect KY 40059-9107 |
| Practice Telephone | 5022287530 |
| Practice Fax Number | 5022287533 |
| Mailing Telephone | 5022287530 |
| Mailing Fax Number | 5022287533 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2013-07-24 |
| Authorized Official Name | LYNN O EGAN (PRESIDENT) |
| Authorized Official Telephone | 5022287530 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | 39726 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100195370 | 05 |
| Street Address |
12945 W HIGHWAY 42 |
| City | PROSPECT |
| State | KY |
| Zip Code | 40059-9107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689638470 | Lynn O. Egan | Internal Medicine | 12945 W Highway 42, Prospect, KY 40059-9107 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932744919 | Cheryl L Young | Counselor | 1703 Victory Court, Prospect, KY 40059 | 2019-11-13 |
| 1790276806 | Harrods Creek Vol Fire Dept Inc | Ambulance | 8905 Us Highway 42, Prospect, KY 40059 | 2018-05-24 |
| 1952754475 | Prospect Pharmacy LLC | Pharmacy | 9549-b Us Highway 42, Prospect, KY 40059 | 2016-07-20 |
| 1972959740 | Raina Chandiramani | Dentist | 11838 Lakestone Way, Prospect, KY 40059 | 2016-05-10 |
| 1750629416 | Sanford Simon | Family Medicine | 6805 Hunter Run Place, Prospect, KY 40059 | 2013-01-30 |
| 1568707743 | Zorre Zeno Kimura | Physical Therapist | 10211 Worthington Lane, Prospect, KY 40059 | 2012-11-29 |
| 1487806634 | Jaclyn Engelsher | Acupuncturist | 10605 Meeting Street, Suite 102, Prospect, KY 40059 | 2008-10-21 |
| 1740454289 | Emily J. Baskin | Massage Therapist | 9509 Us Hwy 42, Suite 207, Prospect, KY 40059 | 2008-04-16 |
| 1942304647 | Paul Thomas Lavelle | Dentist | 13104 Us Hwy 42, Prospect, KY 40059 | 2006-09-12 |
| 1710924055 | Nasir Gardezi | Internal Medicine | 9500 Hayden Creek Court, Prospect, KY 40059 | 2006-06-02 |
| Find all providers in zip 40059 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1821330861 | James L. Bersot Jr. | Internal Medicine | 2406 Belknap Beach Rd, Prospect, KY 40059-9050 | 2013-03-16 |
| 1790077287 | Aditi Mukherji | Internal Medicine | 166 Waterbury Rd Ste 300, Prospect, CT 06712-1246 | 2011-05-03 |
| 1467782466 | Advanced Medical Services | Internal Medicine | 13003 Tattersall Ln, Prospect, KY 40059-9718 | 2010-01-13 |
| 1811124472 | Daniel Bernheim Penner | Internal Medicine | 7211 Leafland Pl, Prospect, KY 40059-9687 | 2009-06-22 |
| 1295758514 | Tina T Yuan | Internal Medicine | 9537 Us Highway 42, Prospect, KY 40059-9301 | 2006-07-26 |
| 1710924055 | Nasir Gardezi | Internal Medicine | 9500 Hayden Creek Court, Prospect, KY 40059 | 2006-06-02 |
| 1033167804 | Greater Waterbury Primary Care Assoc | Internal Medicine | 166 Waterbury Road, Ste 300, Prospect, CT 06712 | 2006-05-04 |
| 1932164134 | Elizabeth V. Bates | Internal Medicine | 9409 Norton Commons Blvd Ste 101, Prospect, KY 40059-7525 | 2006-04-19 |
| 1689638470 | Lynn O. Egan | Internal Medicine | 12945 W Highway 42, Prospect, KY 40059-9107 | 2006-04-17 |
| 1861492373 | Beyla Zuberi | Internal Medicine | 10727 Worthington Ln, Prospect, KY 40059-9586 | 2005-07-26 |
| Find all providers in PROSPECT | ||||
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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.