GENESIS MEDICAL LASER CENTER, LLC (NPI# 1851548218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851548218 |
| Entity Type | Organization |
| Organization Name | GENESIS MEDICAL LASER CENTER, LLC |
| Other Organization Name | GENESIS MEDICAL LASER CTR |
| Practice Address |
1711 Destiny Ln Suite 107 Bowling Green KY 42104-1066 |
| Practice Telephone | 2708426096 |
| Practice Fax Number | 2708426097 |
| Mailing Telephone | 2708426096 |
| Mailing Fax Number | 2708426097 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | MR. DAVID STEMM (MANAGING PARTNER) |
| Authorized Official Telephone | 2708426096 |
| Authorized Official Credential | CLT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Genesis Medical Laser CTR | Doing Business As Name - Organization |
| Street Address |
1711 DESTINY LN SUITE 107 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-1066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053397166 | Leslie Ann Hazel | Dentist | 1711 Destiny Ln, Ste 120, Bowling Green, KY 42104-1066 | 2005-12-20 |
| 1881252534 | Freedom Bridge To Recovery Multicare LLC | Clinic/Center | 1711 Destiny Ln, Bowling Green, KY 42104-1066 | 2019-05-29 |
| 1144703273 | Carmen Ralston | Behavior Technician | 1711 Destiny Ln, Bowling Green, KY 42104-1066 | 2018-09-14 |
| 1922581065 | Janice Belcher | Behavior Technician | 1711 Destiny Ln, Bowling Green, KY 42104-1066 | 2018-09-14 |
| 1750722880 | Richard Warren Brinkman Inc | Clinic/Center | 1711 Destiny Ln, Suite 118, Bowling Green, KY 42104-1066 | 2013-07-17 |
| 1497056451 | Christina Noel | Behavioral Analyst | 1711 Destiny Ln, Suite 106 and 107, Bowling Green, KY 42104-1066 | 2010-11-08 |
| 1568688869 | Daily Denture & Dental Services | Dentist | 1711 Destiny Ln, Ste 120, Bowling Green, KY 42104-1066 | 2007-04-17 |
| 1497809008 | Deborah Kay Champion | Counselor | 1711 Destiny Ln, Ste. 111, Bowling Green, KY 42104-1066 | 2007-01-22 |
| 1740291152 | Cook's Orthopedics, Inc. | Prosthetic/Orthotic Supplier | 1711 Destiny Ln, Suite 121, Bowling Green, KY 42104-1066 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871871780 | Greater Kentucky Wellness Center LLC | Clinic/Center | 101 River Dr, Irvine, KY 40336-1117 | 2011-07-26 |
| 1962704908 | Jackson Pain Management Clinic, Pllc | Clinic/Center | 327 Briarcliff Ln, Danville, KY 40422-9789 | 2010-11-24 |
| 1679873400 | Caremore Pain Management | Clinic/Center | 420 Teays Br, Paintsville, KY 41240-8548 | 2010-10-27 |
| 1023346194 | St. John Neumanns Intergrated Pain Management | Clinic/Center | 1389 Highway 15 N., Jackson, KY 41339 | 2009-11-30 |
| 1972619641 | Pain Care Center | Clinic/Center | 310 S Limestone St, Lexington, KY 40508 | 2006-08-22 |
| 1124537204 | North Dixie Medical Center Pllc | Clinic/Center | 3502 Dixie Hwy, Louisville, KY 40216-5069 | 2017-09-21 |
| 1902329436 | Donald Douglas,md | Clinic/Center | 261 Ruccio Way Ste 190, Lexington, KY 40503-3566 | 2017-07-17 |
| 1124578703 | Pain Management Medicine | Clinic/Center | 715 Shaker Dr, Suite 132, Lexington, KY 40504-3662 | 2016-10-07 |
| 1568834786 | Deschner Medical Services LLC Deboss Neurology & Pain Clinic | Clinic/Center | 360 Amsden Ave, Specialty Suite, Versailles, KY 40383-1851 | 2015-10-27 |
| 1285984484 | Preston Medical Center, LLC | Clinic/Center | 5703 Preston Hwy, Suite B, Louisville, KY 40219-1305 | 2012-09-14 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42104 |
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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.