Stonecrest Family Medicine PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

36516 Issued in KY

Legal business name

STONECREST FAMILY MEDICINE PLLC

Practice address

101 Stonecrest Road
Suite 3
Shelbyville, KY 40065

Phone

(502) 633-5565

Fax

(502) 633-5154

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Ronald E Creque Jr., MD

Title

Owner

Phone

(502) 633-5565

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

Practitioners 9

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

• Ron E Creque Jr., MD

  • Family Medicine Physician
  • Shelbyville, KY
  • NPI 1194717397
  Medicare reassignment Care Compare group NPD
• Paul A Goodlett, MD

  • Family Medicine Physician
  • Shelbyville, KY
  • NPI 1770575979
  Medicare reassignment Care Compare group NPD
• Jinjerita Collins Lucas, CRNP

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1659694081
  Medicare reassignment Care Compare group NPD
• Lauralee C Coleman, PA-C

  • Medical Physician Assistant
  • Shelbyville, KY
  • NPI 1992715940
  Medicare reassignment Care Compare group
• Dana C Kuhn, MS PAC

  • Family Medicine Physician
  • Shelbyville, KY
  • NPI 1801083746
  Medicare reassignment Care Compare group
• Veronica D'Antignac

  • Nurse Practitioner
  • Lithonia, GA
  • NPI 1194823799
  NPD (past)
• Martin A Dixon, D.O.

  • Family Medicine Physician
  • Lithonia, GA
  • NPI 1144334798
  NPD (past)
• Andrea Roche Gayden, ANP-BC

  • Internal Medicine Physician
  • Lilburn, GA
  • NPI 1053723676
  NPD (past)
• Kristi Nicole Kinsey Gotier, MD

  • Internal Medicine Physician
  • Lithonia, GA
  • NPI 1467474247
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1659322808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 STONECREST ROAD",
            "address_2": "SUITE 3",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-633-5565",
            "fax_number": "502-633-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STONECREST ROAD",
            "address_2": "SUITE 3",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-633-5565",
            "fax_number": "502-633-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONECREST FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "CREQUE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-633-5565",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "36516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle A Stephens, MAE, BCBA, LBA
• Lisa B Stephens, M.D.
• Rachel Stilger
• Tami Ruth Stoecker, L.M.T.
• Amanda Stoess
• Sherri Lynn Stover, LCSW
• Kathrin Strachan
• Sarah Nicole Strachan
• Nicole Stricklin
• Threase Stucker, MS, BCBA, LBA

• Primary Care Clinic/Center in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.