Active NPI
Paducah Women'S Clinic PSC
- Obstetrics Physician
- Paducah, KY
National Provider Identifier
1215017447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- Legal business name
- PADUCAH WOMEN'S CLINIC PSC
- Practice address
- 2311 Ky Ave
Paducah, KY 42003-8148 - Phone
- (270) 443-8425
- Fax
- (270) 442-3303
- NPI assigned
- Oct 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jorge M Cardenas, MD
- Title
- President
- Phone
- (270) 443-8425
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | Primary |
Addresses
Primary practice location
2311 Ky Ave
Paducah, KY 42003-8148
Mailing address
PO Box 8148
Paducah, KY 42002-8148
Phone (270) 443-8425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65918658 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040517000805 | KY | Part B Supplier - Clinic/Group Practice | 0345230793 |
Receives reassigned benefits from 2 practitioners Practice locations: Paducah, KY |
National Provider Directory
National Provider Directory- Tax ID family
- Paducah Wome'S Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Obstetrics & Gynecology Nurse Practitioner
- Paducah, KY
- NPI 1114198561
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Paducah, KY
- NPI 1477540508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1600905600000",
"number": "1215017447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8148",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420028148",
"telephone_number": "270-443-8425",
"fax_number": "270-442-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2311 KY AVE",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420038148",
"telephone_number": "270-443-8425",
"fax_number": "270-442-3303"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PADUCAH WOMEN'S CLINIC PSC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A",
"authorized_official_last_name": "CARDENAS",
"authorized_official_first_name": "JORGE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "270-443-8425",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65918658",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.