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

Last updated

Oct 21, 2019By 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. Ronald L Wilson, M.D.NPI 1376511063

Title

President

Phone

(270) 442-8575

Specialties & licenses 2

Addresses

Practitioners 2

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.

• Ronald L Wilson, M.D.

  • Internal Medicine Physician
  • Paducah, KY
  • NPI 1376511063
  Authorized official Same address or phone
• 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": [],
    "endpoints": [],
    "other_names": []
}

• Paducah Ophthalmology ASC LLC (The Eye Surgery Center of Paducah)
• 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.