Paducah Primary Care, P.S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PADUCAH PRIMARY CARE, P.S.C.

Practice address

4620 Village Square Dr
Paducah, KY 42001-7501

Phone

(270) 442-8575

Fax

(270) 442-8783

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ronald L Wilson, M.D.

Title

President

Phone

(270) 442-8575

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Teresa Morgan, ARNP

  • Family Nurse Practitioner
  • Paducah, KY
  • NPI 1275590325
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1497892103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 101",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-442-8575",
            "fax_number": "270-442-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017501",
            "telephone_number": "270-442-8575",
            "fax_number": "270-442-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PADUCAH PRIMARY CARE, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-442-8575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": "65927717",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paducah Ophthalmology ASC LLC
• Paducah Pediatric Dentistry PSC
• Paducah Physiatric Partners P.S.C.
• Paducah Physical Therapy and Pschology Center, PSC
• Paducah Plastic and Reconstructive Surgery
• Paducah Psychiatry Group PSC
• Paducah Public Schools
• Paducah Recovery LLC
• Paducah Surgical Associates, PLLC
• Paducah Vascular Institute PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.