PROFESSIONAL PARK DIAGNOSTICS PLLC (NPI# 1902403264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902403264 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL PARK DIAGNOSTICS PLLC |
| Other Organization Name | PROFESSIONAL PARK DIAGNOSTICS PLLC, , RADIOLOGY |
| Practice Address |
3346 Professional Park Suite A Owensboro KY 42303-4551 |
| Practice Telephone | 2702280405 |
| Practice Fax Number | 2708528924 |
| Mailing Telephone | 2708528931 |
| Mailing Fax Number | 2708528924 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | DEBRA T MATTINGLY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 2708528931 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Professional Park Diagnostics PLLC, , Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235795352 | Professional Park Diagnostics Pllc | Clinic/Center | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-05-14 |
| Street Address |
3346 PROFESSIONAL PARK SUITE A |
| City | OWENSBORO |
| State | KY |
| Zip Code | 42303-4551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899588 | Leslie C Phelps | Nurse Practitioner | 3346 Professional Park, Owensboro, KY 42303-4551 | 2005-05-24 |
| 1235795352 | Professional Park Diagnostics Pllc | Clinic/Center | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-05-14 |
| 1295391480 | Deaconess Clinic, Inc. | Family Medicine | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-05-14 |
| 1841763380 | Deaconess Specialty Physicians, Inc | Internal Medicine | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-01-08 |
| 1104300946 | Brandy Pelphrey | Nurse Practitioner | 3346 Professional Park, Owensboro, KY 42303-4551 | 2018-09-18 |
| 1568813418 | Victoria Edwards | Family Medicine | 3346 Professional Park, Owensboro, KY 42303 | 2016-06-22 |
| 1295022705 | Annie J Wilson | Nurse Practitioner | 3346 Professional Park, Owensboro, KY 42303-4551 | 2011-07-05 |
| 1912070038 | Ramez A Salamah | Internal Medicine | 3346 Professional Park, Suite 440, Owensboro, KY 42303-4551 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218121 | Strive Health Ky LLC | Clinic/Center | 4511 Springhill Road, Owensboro, KY 42303 | 2020-06-02 |
| 1952921991 | Carl P Lewis | Pharmacist | Nation's Medicines, 3000 Alvey Park Drive West, Owensboro, KY 42303 | 2020-04-20 |
| 1386292621 | Alexandra Freudenberg | Occupational Therapist | 2605 New Hartford Road, Owensboro, KY 42303 | 2019-08-29 |
| 1457843815 | Deaconess Clinic Inc | Family Medicine | 2710 Heartland Crossing Blvd, Owensboro, KY 42303 | 2018-06-01 |
| 1225525520 | Claudia Abrams | Nurse Practitioner | 3245 Mount Moriah Ave Ste 10, Owensboro, KY 42303 | 2018-04-23 |
| 1245751965 | Play Works Pediatric Therapy | Early Intervention Provider Agency | 4551 Indian Creek Loop, Owensboro, KY 42303 | 2017-07-03 |
| 1518490952 | Sue Lindsey | Social Worker | 1100 Walnut St., Owensboro, KY 42303 | 2017-04-04 |
| 1972034163 | Megan Nichole Meredith | Counselor | 2707 Breckenridge Street, Suite 4, Owensboro, KY 42303 | 2017-03-21 |
| 1275077786 | Physicians Affiliated Care, Psc | Family Medicine | 2710 Heartland Crossings, Suite B, Owensboro, KY 42303 | 2016-12-19 |
| 1790168516 | Kelli D. Brown | Nurse Practitioner | 2816 Veach Rd Ste 403, Owensboro, KY 42303 | 2015-06-30 |
| Find all providers in zip 42303 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235795352 | Professional Park Diagnostics Pllc | Clinic/Center | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265044523 | Norton Hospitals Inc | Clinic/Center | 4420 Dixie Hwy Ste 108, Louisville, KY 40216-2986 | 2020-08-18 |
| 1952935041 | Gnd Radiology Solutions, LLC | Clinic/Center | 6801 Dixie Hwy Ste 238, Louisville, KY 40258-3961 | 2020-02-27 |
| 1194077248 | Saint Joseph Health System Inc. | Clinic/Center | 1099 Duval St, Suite 150, Lexington, KY 40515-6490 | 2012-10-12 |
| 1164664330 | Pro Imaging Lexington | Clinic/Center | 523 Welllington Way, 180, Lexington, KY 40502 | 2009-04-02 |
| 1962628727 | Central Physicians Imaging | Clinic/Center | 100 Southland Dr, Suite B, Lexington, KY 40503-1927 | 2007-04-18 |
| 1538280078 | Fleming Regional Medical Imaging, Pllc | Clinic/Center | 730 Elizaville Rd, Flemingsburg, KY 41041 | 2007-04-03 |
| 1457480832 | Maggies Enterprises LLC | Clinic/Center | 102 Mountain View Cmns, Pineville, KY 40977-8708 | 2007-03-03 |
| 1447388335 | Norton Hospitals Inc | Clinic/Center | 4960 Norton Healthcare Blvd, Louisville, KY 40241-2831 | 2007-03-01 |
| 1780751487 | Diversified Patient Resources, Inc. | Clinic/Center | 2547 Dell Rd, Louisville, KY 40205-2309 | 2006-11-29 |
| 1174697858 | Neurodiagnostics Inc. | Clinic/Center | 1725 Harrodsburg Rd Ste 100, Lexington, KY 40504-3601 | 2006-11-17 |
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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.