Maria Cristina Atienza PSC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

MARIA CRISTINA ATIENZA PSC

Practice address

110 Roy Kidd Ave
Corbin, KY 40701-1302

Phone

(606) 528-7400

Fax

(606) 528-7449

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Maria C. Atienza, MDNPI 1558371427

Title

Owner

Phone

(606) 528-7400

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Maria C Atienza MD PSC Other name

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 183933

Legal name

MARIA CRISTINA ATIENZA PSC

Doing business as

ATIENZA-ACOB MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Nov 12, 2004

Last certification

Dec 7, 2016

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Sep 9, 2002 in KY

Enrollment address

110 Roy Kidd Ave
Corbin, KY 40701-1302

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Arden M Acob, MD

  • Neurology Physician
  • Corbin, KY
  • NPI 1982614871

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Maria C. Atienza, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Corbin, KY
  • NPI 1558371427

  5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria C. Atienza, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Corbin, KY
  • NPI 1558371427
  Medicare reassignment Care Compare group NPD Authorized official
• Arden M Acob, MD

  • Neurology Physician
  • Corbin, KY
  • NPI 1982614871
  Medicare reassignment Care Compare group NPD
• Kari Renee Honeycutt, APRN

  • Family Nurse Practitioner
  • Corbin, KY
  • NPI 1942642509
  Medicare reassignment Care Compare group NPD
• Ingrid Minor, PA-C

  • Physician Assistant
  • Corbin, KY
  • NPI 1841248507
  Medicare reassignment Care Compare group
• Leslie Sara Johnston, N. P.

  • Primary Care Nurse Practitioner
  • Miracle, KY
  • NPI 1568722304
  Medicare reassignment NPD
• Trisha A Spray, APRN

  • Family Nurse Practitioner
  • London, KY
  • NPI 1447773320
  Medicare reassignment NPD
• Lucinda Smith

  • Physician Assistant
  • Corbin, KY
  • NPI 1023870540
  Medicare reassignment
• Joseph Tye Prewitt, PA-C

  • Physician Assistant
  • Nashville, TN
  • NPI 1154766152

  KY

  Medicare reassignment

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1275543134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 545",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407020545",
            "telephone_number": "606-528-7400",
            "fax_number": "606-528-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ROY KIDD AVE",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011302",
            "telephone_number": "606-528-7400",
            "fax_number": "606-528-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA CRISTINA ATIENZA PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "ATIENZA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-528-7400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35-001726",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maria C Atienza MD PSC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Manoochehr Mazloomdoost P S C (Wellward)
• Cassidy Rae Marcum
• Charles Lee Marcum, M.D.
• Linda S Marcum, MA, CPP
• Veronica Ann Marcum
• Denise Lynn Marlett, BA, PE
• Georgette Marlena Marlow, M.ED, LCADC
• Heather M. Marlow, MA, CCC/SLP
• Cynthia L Marlowe, MA
• John Marr

• Geriatric Medicine (Internal Medicine) Physician in Corbin, KY
• Providers in Corbin, KY by specialty
• Geriatric Medicine (Internal Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.