Keith Wellington Myrick (NPI# 1063402972, PAC ID# 6709834120) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1063402972 |
| PAC ID by PECOS | 6709834120 |
| Professional Enrollment ID | I20050112000077 |
| Full Name | Keith Wellington Myrick |
| Organization Legal Name | SPORTS MEDICINE SURGICAL SPECIALISTS PLLC |
| Address |
309 Guthrie St Louisville KY 40202-1813 |
| Phone Number | 5025853668 |
| Gender | M |
| Credential | DPM |
| Medical School | OHIO COLLEGE OF PODIATRIC MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | PODIATRY |
| Secondary Specialties | ORTHOPEDIC SURGERY, PERIPHERAL VASCULAR DISEASE |
| Group Practice PAC ID | 5597089367 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180088 | NORTON HOSPITALS, INC |
| 151331 | HARRISON COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 200 Missouri Ave, Suite A, Jeffersonville, IN 47130-3061 | 5027218288 | SPORTS MEDICINE SURGICAL SPECIALISTS PLLC |
| 309 Guthrie St, Louisville, KY 40202-1813 | 5025853668 | SPORTS MEDICINE SURGICAL SPECIALISTS PLLC |
| Organization Legal Name | SPORTS MEDICINE SURGICAL SPECIALISTS PLLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott T Rotterman | Podiatry | Sports Medicine Surgical Specialists Pllc | 200 Missouri Ave, Suite A, Jeffersonville, IN 47130-3061 |
| Street Address |
309 GUTHRIE ST |
| City | LOUISVILLE |
| State | KY |
| Zip | 40202-1813 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aaron Becker | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Elizabeth A Mills | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Barry R Pecha | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Ryan J Malone | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephan J Sweitzer | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Kelly M Gollar | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| David H Rosenbaum | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Richard N Medley Iii | Urology | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephanie A Corbett | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Stephanie A Flaspoehler | Nurse Practitioner | First Urology Psc | 100 E Market St, Louisville, KY 40202-1306 |
| Find all physicians in zip 40202 | |||
| City | LOUISVILLE |
| Zip Code | 40202 |
| Specialty | PODIATRY |
| City + Specialty | LOUISVILLE + PODIATRY |
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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.