Pikeville Medical Center, Inc.
Organization Active NPI Multi-Specialty Clinic/Center · Pikeville, KY
NPI 1811774656 · NPPES record last updated Sep 14, 2023
Key facts
- NPI
- 1811774656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- PIKEVILLE MEDICAL CENTER, INC.
- Practice address
- 911 Bypass Rd BLDG a
Pikeville, KY 41501-1602 - Phone
- (606) 430-3500
- Fax
- (606) 432-6762
- NPI assigned
- Sep 14, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- PIKEVILLE MEDICAL CENTER, INC.
Authorized official
- Name
- Michelle Hagy
- Title
- Cfo
- Phone
- (606) 430-3519
Corporate family (same tax ID) 20
Practitioners 21
-
Houston Michael Aaron II, M.D.
-
Dev Krishneshwar Arwikar, M.D.
-
Robert S. Case, M.D.
-
Byron H Christie, MD
-
Steven Hoyt Craig, M.D.
-
Maxwell Ryan Cretcher, D.O.
-
Jonathan Tyler Hammett, M.D.
-
James E Hammond, MD
-
Ravi Jay Jhaveri, MD
-
Melvin Emeka Omodon, M.D.
-
Anahid Pahlawanian, D.O.
-
John Damon Pavlus, M.D.
-
Marcelo Dassow Ribeiro, M.D.
-
Paul Michael Sherman, M.D.
-
Heeseop Shin, M.D.
-
Matthew Czar Dy Taon, MD, RPVI, WCC, CIIP
-
Haider Ali Virani, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231010002023 | TX | Part B Supplier - Clinic/Group Practice | 6709790157 |
Receives reassigned benefits from 21 practitioners Practice locations: San Antonio, TX; Spring, TX; Southlake, TX; San Angelo, TX; Manvel, TX; Longview, TX; Kingwood, TX; Houston, TX… |
National Provider Directory
- Tax ID family
- Pikeville Med Center Inc
- Part of
- Pikeville Med Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
911 Bypass Rd BLDG a
Pikeville, KY 41501-1602
Mailing address
PO Box 432
Pikeville, KY 41502-0432
Phone (606) 430-3500
Other practice location 1
2301 Douglas Dr
San Angelo, TX 76904-5410
Phone (606) 430-3500
Other providers in Pikeville, KY
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
- Pikeville Medical Center, Inc.
All providers in Pikeville, KY · Multi-Specialty Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.