WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE (NPI# 1790075273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790075273 |
| Entity Type | Organization |
| Organization Name | WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE |
| Practice Address |
1605 Avenue of Champions Rm 128 Bowling Green KY 42101-6412 |
| Mailing Address |
Po Box 819020 Dallas TX 75381-9020 |
| Practice Telephone | 9726871877 |
| Practice Fax Number | 9723673434 |
| Mailing Telephone | 9726871877 |
| Mailing Fax Number | 9723673434 |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |
| Authorized Official Name | MR. BILL EDWARDS (DIRECTOR OF SPORTS MEDICINE) |
| Authorized Official Telephone | 2707456026 |
| Authorized Official Credential | ATC, MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Street Address |
1605 AVENUE OF CHAMPIONS RM 128 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42101-6412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861422255 | Billy Tyler Edwards Jr. | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2006-07-03 |
| 1417470477 | Michelle Yvette Karp | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2017-07-21 |
| 1164945267 | Elaine Marie Odum | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2017-07-20 |
| 1881117901 | John Robert Erwin Jr. | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2017-07-20 |
| 1306369491 | Joshua Aaron Lumpkin | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2017-07-20 |
| 1932635695 | Hannah Elizabeth Zurhellen | Specialist/Technologist | 1605 Avenue of Champions, Smith Stadium West - Room 133, Bowling Green, KY 42101-6412 | 2017-05-02 |
| 1417304262 | Katherine Helen Gorecki | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101-6412 | 2016-05-23 |
| 1902262884 | Bryan Schneider | Specialist/Technologist | 1605 Avenue of Champions, Smith Stadium West - Rm 129, Bowling Green, KY 42101-6412 | 2016-01-08 |
| 1023221884 | Paula Upright | Specialist/Technologist | 1605 Avenue of Champions, 1820 Ea Diddle Arena, Bowling Green, KY 42101 | 2007-05-08 |
| 1548480833 | William Jeremy Steakley | Specialist/Technologist | 1605 Avenue of Champions, Bowling Green, KY 42101 | 2007-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608827 | Heidi Denise Estes | Nurse Practitioner | 651 U.S. 31 W Bypass Ste 106, Bowling Green, KY 42101 | 2020-10-29 |
| 1205476561 | Emily Nell Conner | Pharmacist | 350 West Us 31 Bypass, Bowling Green, KY 42101 | 2020-01-14 |
| 1598304180 | Elizabeth Page Appling | Nurse Practitioner | 1681 Normal Dr., Bowling Green, KY 42101 | 2019-12-30 |
| 1598306227 | Heather Wells | Nurse Practitioner | 427 U.S. 31w Bypass, Bowling Green, KY 42101 | 2019-10-03 |
| 1275182255 | The Kidz Club-pdn, LLC | Nursing Care | 1537 Highway 185, Suite 3, Bowling Green, KY 42101 | 2019-09-11 |
| 1841756525 | Balance Therapeutic Care, Counseling Services LLC | Counselor | 661 A, 31-w Bypass, Bowling Green, KY 42101 | 2019-02-18 |
| 1184104895 | Paige Spear | Specialist | 661 Us 31w Byp Ste C, Bowling Green, KY 42101 | 2018-08-21 |
| 1205364411 | Amanda Katherin Walden | Dentist | 725 A Kenton Street, Bowling Green, KY 42101 | 2017-06-01 |
| 1932632098 | Tj & L Consulting, LLC | In Home Supportive Care | 661 Us 31w By-pass, Suite G, Bowling Green, KY 42101 | 2017-04-06 |
| 1265974117 | Kentucky Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1473 Kentucky Street, Bowling Green, KY 42101 | 2016-11-09 |
| Find all providers in zip 42101 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366733222 | Western Kentucky University | Clinic/Center | 1906 College Heights Blvd, Bowling Green, KY 42101-1000 | 2011-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710300249 | A.b. Elementary | Clinic/Center | 641 Ky Hwy 80 West, Combs, KY 41729 | 2014-02-04 |
| 1316360167 | East Perry Elementary | Clinic/Center | 1559 E Ky Highway 80, Hazard, KY 41701-8516 | 2014-01-30 |
| 1063534196 | Lincoln County Health Dept | Clinic/Center | 101 Old Fort Rd, Stanford, KY 40484-8540 | 2007-04-06 |
| 1972625002 | Lincoln County Health Department | Clinic/Center | 60 Education Way, Stanford, KY 40484-8411 | 2007-04-06 |
| 1881716918 | Lincoln County Health Department | Clinic/Center | 285 Education Way, Stanford, KY 40484-8411 | 2007-04-06 |
| 1699897546 | Lincoln County Health Department | Clinic/Center | 3425 Highway 198, Mckinney, KY 40448 | 2007-04-04 |
| 1477674752 | Lincoln County Health Department | Clinic/Center | 75 Tick Ridge Rd, Waynesburg, KY 40489-8202 | 2007-04-03 |
| 1043332091 | Lincoln County Health Department | Clinic/Center | 342 Education Way, Stanford, KY 40484 | 2007-04-03 |
| 1548382500 | Lincoln County Health Department | Clinic/Center | 345 Waynesburg Road, Waynesburg, KY 40489 | 2007-04-03 |
| 1548382534 | Lincoln County Health Department | Clinic/Center | 93 N College Street, Hustonville, KY 40437 | 2007-04-03 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42101 |
Please comment or provide details below to improve the information on WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE.
| 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.