Individual provider Active NPI

Alicia D. Myers, PA-C

  • Physician Assistant
  • Manchester, KY
National Provider Identifier
1720340375
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC110 Issued in KY
Practice address
65 Glenndale Rd
Suite 1
Manchester, KY 40962-6212
Phone
(606) 599-2508
Fax
(606) 599-2507
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC110 KY Primary

Addresses

Primary practice location

65 Glenndale Rd
Suite 1
Manchester, KY 40962-6212

Mailing address

509 Memorial Dr
Suite 2
Manchester, KY 40962-6195
Phone (606) 598-5104

Other names 1

  • Alicia D. Cook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000115 KY Practitioner - Physician Assistant 8921254129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockcastle County Hospital, Inc.Group PAC ID 6103727433, 38 clinicians

Practice addresses (Care Compare)

140 Newcomb Ave
Mt Vernon, KY 40456-2725

140 Newcomb Ave
Mt Vernon, KY 40456-2728
Phone (606) 256-4148

145 Newcomb Ave
Mount Vernon, KY 40456-2728

Hospital & facility affiliations

  • Rockcastle County Hospital, Inc. Hospital, Mount Vernon, KY, CCN 180115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rockcastle County Hospital, Inc. Physician Assistant CurrentSince Oct 22, 2013 Accepting new patients
Rockcastle Ventures Inc. Doing Business As Rockcastle Clinic Physician Assistant Current Accepting new patients
Rockcastle County Hospital, Inc. CurrentSince Oct 22, 2013 Accepting new patients

Locations

140 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-3232

145 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-2195

Interoperability endpoints

  • Direct secure messaging: rhcamyers@yourcarecommunity.org
  • Direct secure messaging: alicia.myers@rpa.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1720340375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MEMORIAL DR",
            "address_2": "SUITE 2",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626195",
            "telephone_number": "606-598-5104",
            "fax_number": "606-598-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 GLENNDALE RD",
            "address_2": "SUITE 1",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626212",
            "telephone_number": "606-599-2508",
            "fax_number": "606-599-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "ALICIA",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "COOK",
            "middle_name": "D.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.