Stephanie Diane Geraci (NPI# 1770954745, PAC ID# 5395046254) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1770954745 |
| PAC ID by PECOS | 5395046254 |
| Professional Enrollment ID | I20151217001929 |
| Full Name | Stephanie Diane Geraci |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Address |
128 Sugar Maple Dr Auburn KY 42206-5352 |
| Phone Number | 2705425500 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4880596592 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180066 | LOGAN MEMORIAL HOSPITAL |
| 180051 | JENNIE STUART MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 128 Sugar Maple Dr, Auburn, KY 42206-5352 | 2705425500 | LOGAN PHYSICIAN PRACTICE LLC |
| 223 Burley Ave, Hopkinsville, KY 42240-8725 | 2708876565 | FAIRVIEW PHYSICIANS NETWORK LLC |
| 975 Hopkinsville Rd, Russellville, KY 42276-9774 | 2707259090 | LOGAN PHYSICIAN PRACTICE LLC |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adam W Ellis | General Surgery | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| James C Dodson | Internal Medicine | Logan Physician Practice LLC | 147 E 5th St, Russellville, KY 42276-1903 |
| Cynthia Jo Bond | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Blair R Mendoza | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Gillian J Stuart | General Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Charles H Mathis | Family Medicine | Logan Physician Practice LLC | 975 Hopkinsville Rd, Russellville, KY 42276-9774 |
| Steve G Salyers | Orthopedic Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Cynthia J Finley | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Trisha K Campbell | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Street Address |
128 SUGAR MAPLE DR |
| City | AUBURN |
| State | KY |
| Zip | 42206-5352 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adam W Ellis | General Surgery | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Cynthia Jo Bond | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Blair R Mendoza | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Cynthia J Finley | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Trisha K Campbell | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James M Staples | Nurse Practitioner | Staples Health Clinic LLC | 104 E Main St, Auburn, KY 42206-5106 |
| Stacia A Staples | Nurse Practitioner | Staples Health Clinic LLC | 104 E Main St, Auburn, KY 42206-5106 |
| City | AUBURN |
| Zip Code | 42206 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | AUBURN + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.