Mary Cordellia Dwyer (NPI# 1255808747, PAC ID# 8123363140) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1255808747 |
| PAC ID by PECOS | 8123363140 |
| Professional Enrollment ID | I20181219003573 |
| Full Name | Mary Cordellia Dwyer |
| Organization Legal Name | PENNYROYAL REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC |
| Address |
506 Hopkinsville St Greenville KY 42345-1104 |
| Phone Number | 2703385211 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7911803440 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180093 | BAPTIST HEALTH MADISONVILLE |
| Address | Phone | Organization |
|---|---|---|
| 506 Hopkinsville St, Greenville, KY 42345-1104 | 2703385211 | PENNYROYAL REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC |
| 200 Clinic Dr, Madisonville, KY 42431-1661 | 2708218874 | PENNYROYAL REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC |
| Organization Legal Name | PENNYROYAL REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC |
| Physicians | 32 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer R. Koranyi | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 737 B N Dr, Hopkinsville, KY 42240-2620 |
| Shandi Lynne Damron | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 1350 Us Hwy 62 W, Princeton, KY 42445-6106 |
| Rachel Eliazbeth Cole | Nurse Practitioner | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 739 N Dr, Hopkinsville, KY 42240-2620 |
| Steven L Thore | Psychiatry | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Wendy Wilson-hargrove | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 15095 Fort Campbell Blvd, Suite B, Oak Grove, KY 42262-9301 |
| Danielle Marie Smith | Psychologist, Clinical | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Kerry Bordieri | Psychologist, Clinical | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Kelley Jean Willig | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Randy A Hultberg | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Llewelyn N Hortillosa | Psychiatry | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 735 N Dr, Hopkinsville, KY 42240-2620 |
| Street Address |
506 HOPKINSVILLE ST |
| City | GREENVILLE |
| State | KY |
| Zip | 42345-1104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark Allen Monroe Jr. | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 506 Hopkinsville St, Greenville, KY 42345-1104 |
| Lorraine Mccarthy | Clinical Social Worker | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 506 Hopkinsville St, Greenville, KY 42345-1104 |
| Marilyn G. Thomas | Clinical Nurse Specialist | Pennyroyal Regional Mental Health Mental Retardation Board Inc | 506 Hopkinsville St, Greenville, KY 42345-1104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacob Scott Hodskins | Hematology/oncology | Owensboro Health Medical Group Inc | 420 Hopkinsville St, Greenville, KY 42345-1102 |
| Dina M Holland | Clinical Social Worker | Community Health Centers of Western Kentucky, Inc. | 480 Hopkinsville St, Greenville, KY 42345-1124 |
| John N Vitali | Emergency Medicine | Alligatorfish Emergency Physicians LLC | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Jacquelyn Kirby | Nurse Practitioner | Community Health Centers of Western Kentucky, Inc. | 480 Hopkinsville St, Greenville, KY 42345-1124 |
| Andrew D Pierce | Emergency Medicine | Alligatorfish Emergency Physicians LLC | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| James K Slaton | Clinical Social Worker | Community Health Centers of Western Kentucky, Inc. | 480 Hopkinsville St, Greenville, KY 42345-1124 |
| Charles F Hobelmann Iii | Emergency Medicine | Alligatorfish Emergency Physicians LLC | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Lisa G Pagel | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Lisa K Dukes | Nurse Practitioner | Community Health Centers of Western Kentucky, Inc. | 480 Hopkinsville St, Greenville, KY 42345-1124 |
| Melissa Gail Fitch | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Find all physicians in zip 42345 | |||
| City | GREENVILLE |
| Zip Code | 42345 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GREENVILLE + 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.