Wyoming Medicine and Pharmacy LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WYOMING MEDICINE AND PHARMACY LLC

Doing business as

Kentuckiana Medicine

Practice address

443 Spring St
Suite 303
Jeffersonvlle, IN 47130-4494

Phone

(812) 913-4416

Fax

(812) 213-8408

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rafael F Cruz, M.D.NPI 1588620207

Title

Owner

Phone

(859) 468-5065

Specialties & licenses 1

Addresses

Other names 1

• Kentuckiana Medicine Doing business as

Locations

Practitioners 1

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.

• Rafael F Cruz, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jeffersonville, IN
  • NPI 1588620207
  Authorized official Same address or phone

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1104229426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 SPRING ST",
            "address_2": "SUITE 303",
            "city": "JEFFERSONVLLE",
            "state": "IN",
            "postal_code": "471304494",
            "telephone_number": "812-913-4416",
            "fax_number": "812-213-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 SPRING ST",
            "address_2": "SUITE 303",
            "city": "JEFFERSONVLLE",
            "state": "IN",
            "postal_code": "471304494",
            "telephone_number": "812-913-4416",
            "fax_number": "812-213-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING MEDICINE AND PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-468-5065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentuckiana Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noell L Rowan, LCSW
• Sydney Elizabeth Sims, PA-C
• Samantha Blain Sisco, NP
• Christopher Ryan Von Kaenel, PA-C
• Jacqueline Anne Williams, OD
• Melissa Jean Yannetti, DO

• General Practice Physician in Jeffersonvlle, IN
• Providers in Jeffersonvlle, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.