| Berea Walk-in Clinic | |
|
245 Prince Royal Dr Suite A Berea KY 40403-1471 | |
| (859) 582-7663 | |
| (859) 335-1560 |
| Full Name | Berea Walk-in Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 245 Prince Royal Dr, Berea, Kentucky |
| Authorized Official Name and Position | Fadi Bacha (PRESIDENT/OWNER) |
| Authorized Official Contact | 8593129674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berea Walk-in Clinic 245 Prince Royal Dr Suite A Berea KY 40403-1471 Ph: (859) 582-7663 | Berea Walk-in Clinic 245 Prince Royal Dr Suite A Berea KY 40403-1471 Ph: (859) 582-7663 |
| NPI Number | 1437574613 |
|---|---|
| Provider Enumeration Date | 02/25/2014 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 6901039197 |
|---|---|
| Medicare Enrollment ID | O20140423001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437574613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 32006 (Kentucky) | Primary |
| 363A00000X | Physician Assistant | PA1103 (Kentucky) | Secondary |
| 363L00000X | Nurse Practitioner | 3008382 (Kentucky) | Secondary |
| Provider Name | Fadi Bacha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639157456 PECOS PAC ID: 6305741067 Enrollment ID: I20031204001159 |
| Provider Name | Rezkalla A Butros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023037082 PECOS PAC ID: 1557268331 Enrollment ID: I20040513000932 |
| Provider Name | Nicola Jabbour |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740485168 PECOS PAC ID: 1254456189 Enrollment ID: I20100916000142 |
| Provider Name | Elena Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598139842 PECOS PAC ID: 6305140492 Enrollment ID: I20160210001617 |
| Provider Name | Kristin Johnsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245783554 PECOS PAC ID: 4284922659 Enrollment ID: I20161018001718 |
| Provider Name | Stephanie Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073096616 PECOS PAC ID: 6406100601 Enrollment ID: I20181106002259 |
| Provider Name | Emily D Mcalister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427660893 PECOS PAC ID: 7416367180 Enrollment ID: I20201109001204 |
White House Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 104 Legacy Dr, Berea, KY 40403 Phone: 859-986-2323 Fax: 859-986-7728 | |
Berea Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Estill St, Berea, KY 40403 Phone: 859-986-3151 | |
Department Of Veterans Affairs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 Pauline Dr, Berea, KY 40403 Phone: 859-233-4511 Fax: 859-986-1289 | |
Faith Dental Of Berea Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Richmond Rd N, Berea, KY 40403 Phone: 859-986-8491 | |
Berea Health Ministry, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Estill Street, Berea, KY 40403 Phone: 859-986-1274 Fax: 859-986-1279 | |
Dr. Gary E. King Optometrist Psc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 Boone St, Berea, KY 40403 Phone: 859-986-7027 Fax: 859-986-4749 |