| Dr Gregory Allen Rupp, MD | |
|
401 Highland Park Dr, Richmond, KY 40475-3839 | |
| (859) 626-7700 | |
| (859) 626-7890 |
| Full Name | Dr Gregory Allen Rupp |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 401 Highland Park Dr, Richmond, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356571053 | NPI | - | NPPES |
| 300038701 | Medicaid | IN | |
| 412840126 | Other | IN | MEDICARE |
| 7100228010 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 45407 (Kentucky) | Primary |
| Entity Name | Clark Regional Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780356253 PECOS PAC ID: 9739337569 Enrollment ID: O20120919000575 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gregory Allen Rupp, MD 1010 Main St S, Mc Kee, KY 40447-7089 Ph: (859) 626-7700 | Dr Gregory Allen Rupp, MD 401 Highland Park Dr, Richmond, KY 40475-3839 Ph: (859) 626-7700 |
Richard A Blum, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 793 Eastern Byp, Suite 110, Richmond, KY 40475 Phone: 888-732-4293 Fax: 859-623-7362 | |
Jenna Richards, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 793 Eastern Byp Ste 110, Richmond, KY 40475 Phone: 859-624-2020 Fax: 859-623-7362 | |
Praveena M Salins, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 793 Eastern Byp, Suite 110, Richmond, KY 40475 Phone: 859-624-2020 Fax: 859-623-7362 | |
Alison Moncayo, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 401 Highland Park Dr, Richmond, KY 40475 Phone: 859-626-7700 Fax: 859-626-7890 | |
Melody Stewart-cyrus, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 401 Highland Park Dr, Richmond, KY 40475 Phone: 859-626-7700 | |
Shanna Sharber, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 401 Highland Park Dr, Richmond, KY 40475 Phone: 859-626-7700 Fax: 859-626-7890 |