Jackson Purchase ER Physicians, PSC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

JACKSON PURCHASE ER PHYSICIANS, PSC

Practice address

1530 Lone Oak Rd
Paducah, KY 42003-7901

Phone

(270) 444-0878

Fax

(270) 444-6252

NPI assigned

Sep 27, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian W Vanderboegh, MDNPI 1356337182

Title

President

Phone

(270) 444-0878

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian W Vander Boegh, MD

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1356337182
  NPD (past) Authorized official
• Philip E Anderson, MD

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1669469300
  NPD (past)
• John W Brazzell, MD

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1447246186

  Emergency Medicine

  NPD (past)
• Jeremy Lee Klope, M.D.

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1790922011
  NPD (past)
• Joseph M O'Bryan, MD

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1770570400

  Emergency Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1093701823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477010078",
            "telephone_number": "800-467-2394",
            "fax_number": "270-444-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037901",
            "telephone_number": "270-444-0878",
            "fax_number": "270-444-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PURCHASE ER PHYSICIANS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "VANDERBOEGH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-444-0878",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65911323",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Irvan, APRN
• Chase Cullen Irvin, OTR/L
• Victoria Ivanukoff, DO
• J Michael Giannini PSC (J Michael Giannini MD PSC)
• J.F. Wilson Wellness Center, LLC.
• Jackson Purchase Medical Associates, PSC
• Brooke A Jackson, PA-C
• Catherine Marie Jackson, DNAP, CRNA
• Deana K. Jackson, MOT, OTR/L
• Jonathan Jackson

• Emergency Medicine Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Emergency Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.