NEUROLOGY GROUP OF PADUCAH, PLLC (NPI# 1790893964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790893964 |
| Entity Type | Organization |
| Organization Name | NEUROLOGY GROUP OF PADUCAH, PLLC |
| Practice Address |
2603 Kentucky Ave Suite 402 Paducah KY 42003-3814 |
| Practice Telephone | 2704432830 |
| Practice Fax Number | 2704437108 |
| Mailing Telephone | 2704432830 |
| Mailing Fax Number | 2704437108 |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2011-03-24 |
| Authorized Official Name | DR. VAN M WOELTZ (OWNER) |
| Authorized Official Telephone | 2704432830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
87743 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NEUROLOGY GROUP PTAN | 1391 | 01 |
| KY | 65939647 | 05 |
| Street Address |
2603 KENTUCKY AVE SUITE 402 |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003-3814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487656658 | Theodore Edwin Clyde Davies | Neurological Surgery | 2603 Kentucky Ave, Ste 404, Paducah, KY 42003-3814 | 2005-06-01 |
| 1760873939 | Brandy Buckhalter | Nurse Practitioner | 2603 Kentucky Ave, Suite 105, Paducah, KY 42003-3814 | 2015-02-10 |
| 1699179895 | Baptist Health Medical Group Inc | Nurse Practitioner | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2014-10-17 |
| 1568862951 | Amy Knees | Nurse Practitioner | 2603 Kentucky Ave, Suite 301, Paducah, KY 42003-3814 | 2014-09-04 |
| 1932519766 | Chadwick Bassi | Podiatrist | 2603 Kentucky Ave, Suite 105, Paducah, KY 42003-3814 | 2014-05-01 |
| 1679998140 | Jonathan Gipson | Nurse Practitioner | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2014-02-20 |
| 1962832295 | Western Baptist Medical Ventures, Inc | Nurse Practitioner | 2603 Kentucky Ave, Suite 201, Paducah, KY 42003-3814 | 2013-11-22 |
| 1487924353 | Thomas James Gruber | Neurological Surgery | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2012-01-09 |
| 1013229368 | William Lee Titsworth | Neurological Surgery | 2603 Kentucky Ave, Suite 402, Paducah, KY 42003-3814 | 2010-07-01 |
| 1568699478 | Western Baptist Medical Ventures, Inc | Clinical Nurse Specialist | 2603 Kentucky Ave, Suite 304, Paducah, KY 42003-3814 | 2009-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447269451 | Van M Woeltz | Psychiatry & Neurology | 1532 Lone Oak Rd Ste 150, Paducah, KY 42003-7940 | 2006-08-07 |
| 1215110796 | Joseph Charles Ashburn | Psychiatry & Neurology | 2603 Kentucky Ave, Suite 304, Paducah, KY 42003-3814 | 2007-12-07 |
| 1932281904 | Jimmy Edward Couch | Psychiatry & Neurology | 1532 Lone Oak Rd, Suite 143, Paducah, KY 42003-7913 | 2006-10-19 |
| 1710077110 | John Edward Grubbs | Psychiatry & Neurology | 2603 Kentucky Ave, Suite 304, Paducah, KY 42003-3814 | 2006-10-14 |
| 1083704480 | Purchase Neurology Psc | Psychiatry & Neurology | 225 Medical Center Drive, Suite 402, Paducah, KY 42003 | 2006-10-14 |
| 1154330157 | Niranjan Siva | Psychiatry & Neurology | 1532 Lone Oak Rd, Suite 150, Paducah, KY 42003-7913 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215469366 | Paige Elise Sutton | Psychiatry & Neurology | 740 S Limestone Rm L-445, Lexington, KY 40536 | 2017-03-29 |
| 1356872238 | Fred Ochieng Odago | Psychiatry & Neurology | 3518 Willowood Rd, Lexington, KY 40517-2760 | 2017-03-23 |
| 1558811323 | Kentucky Medical Center, Psc | Psychiatry & Neurology | 208 Legends Ln, Suite 130, Lexington, KY 40505-3285 | 2016-10-05 |
| 1114372141 | Marwa Ali Mahgoub Elnazeir | Psychiatry & Neurology | 401 E Chestnut St Ste 500, Louisville, KY 40202-5700 | 2016-04-27 |
| 1427411537 | James Lamb | Psychiatry & Neurology | 500 S Preston St Dept Of, Hsc #113, Louisville, KY 40202-1702 | 2016-04-05 |
| 1194111807 | Murali Kolikonda | Psychiatry & Neurology | 500 S. Preston St., Rm. 113, Louisville, KY 40202 | 2015-04-09 |
| 1366852311 | Ruta Nandan Yardi | Psychiatry & Neurology | 740 S Limestone Ste B101, Lexington, KY 40536-0284 | 2014-04-30 |
| 1639511041 | Sushanth Rao Aroor | Psychiatry & Neurology | 740 S Limestone L445, Lexington, KY 40508-0284 | 2013-07-26 |
| 1629412150 | Lei Zhou | Psychiatry & Neurology | 740 S Limestone Room L-445, Lexington, KY 40536-1200 | 2013-04-26 |
| 1629344882 | Patricia A Kleinholz-owens | Psychiatry & Neurology | 1800 Nicholasville Rd Ste 301, Lexington, KY 40503-1443 | 2012-03-31 |
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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.