Angela Yvonne Cundiff-Roy, ARNP

Individual provider Active NPI Internal Medicine Physician · Russell Springs, KY

NPI 1821068552 · NPPES record last updated Feb 22, 2011

Key facts

NPI
1821068552
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
2287P (KY)
Practice address
72 Joe T. Pettey Dr.
Russell Springs, KY 42642
Phone
(270) 866-4357
Fax
(270) 858-4957
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2287PKYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenview Primecare, LLC. Internal Medicine Past Accepting new patients
Avante Garde Health Centers, LLC Past Accepting new patients
Westlake Regional Hospital Medical Group Past Accepting new patients
Adair County Hospital District Past Accepting new patients
ER & Associates Nurse Practitioner Past Accepting new patients
Greenview Specialty Associates LLC Past Accepting new patients
Southern Kentucky Medical Associates, PSC Past
since Aug 26, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2287P KY Yes
Nurse Practitioner 363L00000X 2287P KY

Addresses

Primary practice location

72 Joe T. Pettey Dr.
Russell Springs, KY 42642

Mailing address

PO Box 1383
Russell Springs, KY 42642-1383
Phone (270) 866-4357

Other identifiers

IdentifierTypeStateIssuer
78001266MedicaidKY

Other providers in Russell Springs, KY

All providers in Russell Springs, KY · Internal Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.