Emerald Therapy Center, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

EMERALD THERAPY CENTER, LLC

Practice address

1640 McCracken Blvd Ste 200
Paducah, KY 42001-9562

Phone

(270) 534-5128

Fax

(270) 477-0007

NPI assigned

Oct 21, 2024

Organization subpart

Yes

Parent organization

EMERALD THERAPY CENTER LLCAs reported in NPPES

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

Authorized official

Name

Shelly Beth Baer, LCSW

Title

Owner

Phone

(270) 205-8895

Specialties & licenses 1

Addresses

Other names 1

• Emerald Medical Group Doing business as

Tax ID family

Emerald Therapy Centerllc M3 organizations share this tax ID, including this one

Part of

Emerald Therapy Centerllc M

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Emerald Therapy Center, LLC

  • Rural Health Clinic/Center
  • Paducah, KY
  • NPI 1154002079
  NPD tax ID
• Emerald Therapy Center, LLC

  • Rural Health Clinic/Center
  • Murray, KY
  • NPI 1649881335
  NPD tax ID

Locations

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1205657384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 MCCRACKEN BLVD STE 200",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019562",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MCCRACKEN BLVD STE 200",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019562",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1019 Paducah Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Mayfield",
            "state": "KY",
            "postal_code": "420663616",
            "country_code": "US",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2327 New Holt Rd",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420017404",
            "country_code": "US",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 Village Square Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420017552",
            "country_code": "US",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2520 New Holt Rd Ste I",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420017547",
            "country_code": "US",
            "telephone_number": "270-588-3916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Poplar St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420712577",
            "country_code": "US",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERALD THERAPY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMERALD THERAPY CENTER LLC",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "BAER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-205-8895",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick K Ellison, M.D.
• Jacob Elrod, MD
• Madisen G Elrod
• Emerald Therapy Center, LLC
• Emerald Therapy Center, LLC
• Emerald Therapy Center, LLC
• Ericka Emerson
• Gary Thomas England, MD
• Tanna Marie England
• Kathryn White Englert, LPCC-S, NBCC

• All providers in Paducah, KY
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.