CAROL B PEDDICORD (NPI# 1912990607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912990607 |
| Entity Type | Individual |
| Full Name | CAROL B PEDDICORD |
| Credential | MD |
| Practice Address |
252 Burkesville Rd Albany KY 42602-1604 |
| Practice Telephone | 6063870323 |
| Practice Fax Number | 6063870310 |
| Mailing Telephone | 6063870323 |
| Mailing Fax Number | 6063870310 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2018-12-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25961 | KY | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 25961 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64259617 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 102 N Washington St, Albany, KY 426021302 | 6063872025 | 6063870310 |
| Street Address |
252 BURKESVILLE RD |
| City | ALBANY |
| State | KY |
| Zip Code | 42602-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922539188 | Commonwealth Health Corporation, Inc | Nurse Practitioner | 252 Burkesville Rd, Albany, KY 42602-1604 | 2017-03-21 |
| 1760874713 | Carol B Peddicord Md Pllc | Family Medicine | 252 Burkesville Rd, Albany, KY 42602-1604 | 2015-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649707571 | Sarah Stockton Dba Stockton Speech Therapy | Speech-Language Pathologist | 330 N. Clearfork Rd., Albany, KY 42602 | 2017-05-23 |
| 1205289709 | Sarah Stockton | Speech-Language Pathologist | 18 Clearfork Rd, Albany, KY 42602 | 2016-07-20 |
| 1093164436 | Pagie Denney-jones | Social Worker | 104 Washington St., Albany, KY 42602 | 2016-06-07 |
| 1255717278 | Shearer Drug Inc | Durable Medical Equipment & Medical Supplies | 260 Burkesville Rd, Albany, KY 42602 | 2015-07-31 |
| 1790030625 | Jennifer Ann Dyer | Pharmacist | 800 North Cross Street, Albany, KY 42602 | 2012-07-17 |
| 1235364076 | Lake Cumberland District Health Dept | Public Health or Welfare | 650 High School Dr., Albany, KY 42602 | 2009-05-22 |
| 1316110034 | Lydia Sue Irwin | Social Worker | 218 Irwin Daniels Road, Albany, KY 42602 | 2008-04-03 |
| 1205975414 | Horizon Adult Health Care LLC | Case Management | 97 Foothills Avenue, Albany, KY 42602 | 2007-02-05 |
| 1104973635 | Clinton County Board of Education | Local Education Agency (LEA) | Clinton County Board of Education, North Highway 127, Albany, KY 42602 | 2007-01-05 |
| 1023114451 | Susan Elayne Cash | Dentist | 111 Cross St, Albany, KY 42602 | 2006-09-15 |
| Find all providers in zip 42602 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1407492796 | American Ecare | Family Medicine | 3 Computer Dr W Ste 107, Albany, NY 12205-1621 | 2019-11-21 |
| 1124678347 | Carehere LLC | Family Medicine | Carehere Clinic- City of Albany, Ga, 2000 North Monroe Street, Albany, GA 31701 | 2019-09-19 |
| 1790332831 | Granland3 LLC | Family Medicine | 2622 Dawson Rd, Albany, GA 31707-1609 | 2019-08-22 |
| 1295397065 | Cerrito Creek Family Medicine Inc | Family Medicine | 400 Evelyn Ave., St. 107, Albany, CA 94706 | 2019-07-02 |
| 1487190526 | Tracey Anyanwu | Family Medicine | 539 N Westover Blvd, 133, Albany, GA 31707-1951 | 2017-01-12 |
| 1275911828 | St Claire Gitau Sumaili | Family Medicine | 2403 Osler Ct Ste A, Albany, GA 31707-0205 | 2015-05-15 |
| 1235516071 | Daniel Barton Mosher | Family Medicine | 2605 Willetta St Sw Ste D1, Albany, OR 97321-3481 | 2015-04-30 |
| 1508129214 | Alan Shifman Charles | Family Medicine | 741 Gateview Ave, Albany, CA 94706-1029 | 2012-06-18 |
| 1770840324 | Joseph A Kelly | Family Medicine | 27 Park Ln E, #2, Albany, NY 12204-1960 | 2012-04-20 |
| Find all providers in ALBANY | ||||
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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.