Pediatric Associates of Elizabethtown, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC

Practice address

111 Helmwood Plaza Dr
Elizabethtown, KY 42701-2480

Phone

(270) 737-4808

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Marquita H Ball, M.D.NPI 1538127097

Title

Partner

Phone

(270) 737-4808

Specialties & licenses 1

Addresses

Other identifiers 2

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 4

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

• Marquita Hanna Ball, MD

  • Pediatrics Physician
  • Elizabethtown, KY
  • NPI 1538127097
  NPD (past) Authorized official
• Veronica Hurst Cammack, MD

  • Pediatrics Physician
  • Elizabethtown, KY
  • NPI 1144367533
  NPD (past)
• Melissa Bland Flynn, MD

  • Pediatrics Physician
  • Elizabethtown, KY
  • NPI 1174574446
  NPD (past)
• Leigh Anne Pearman, MD

  • Pediatrics Physician
  • Elizabethtown, KY
  • NPI 1346276409
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1891855359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HELMWOOD PLAZA DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012480",
            "telephone_number": "270-737-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HELMWOOD PLAZA DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012480",
            "telephone_number": "270-737-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "MARQUITA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "270-737-4808",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT GROUP NUMBER",
            "identifier": "1054638",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65929457",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Falenia Runae Payton, LPCC
• Ryan H Peace, D.M.D.
• Alida Rutledge Pearce, CSW
• Leigh Anne Pearman, MD
• Eric Keith Pearson, RPH
• Pegasus Farm Inc
• Robert Mack Pemberton, RPH
• Ivan Pena Sing, M.D.
• Cayleigh Pence, APRN
• Edna Jean Pence, CNM

• Primary Care Clinic/Center in Elizabethtown, KY
• Providers in Elizabethtown, 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 Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.