| Pennyroyal Healthcare Services, Inc. | |
|
1102 S Virginia St Hopkinsville KY 42240-3579 | |
| (270) 365-0227 | |
| (270) 365-2559 |
| Full Name | Pennyroyal Healthcare Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1102 S Virginia St, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Kecia Fulcher (CEO/DIRECTOR) |
| Authorized Official Contact | 2708862205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennyroyal Healthcare Services, Inc. 310 Hawthorne St Princeton KY 42445-1622 Ph: (270) 365-0227 | Pennyroyal Healthcare Services, Inc. 1102 S Virginia St Hopkinsville KY 42240-3579 Ph: (270) 365-0227 |
| NPI Number | 1124319942 |
|---|---|
| Provider Enumeration Date | 04/27/2011 |
| Last Update Date | 03/16/2018 |
| Medicare PECOS PAC ID | 6002076700 |
|---|---|
| Medicare Enrollment ID | O20120404000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124319942 | NPI | - | NPPES |
| 7100200060 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Mary L Dillard |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1306880034 PECOS PAC ID: 1456356880 Enrollment ID: I20060919000099 |
| Provider Name | Pankajkumar C Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043412356 PECOS PAC ID: 7214021161 Enrollment ID: I20070922000002 |
| Provider Name | Elizabeth Scheidler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467776716 PECOS PAC ID: 2365579901 Enrollment ID: I20100612000003 |
| Provider Name | Hunter Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801068861 PECOS PAC ID: 8820268659 Enrollment ID: I20110902000262 |
| Provider Name | Simon Spilkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578728002 PECOS PAC ID: 6305017062 Enrollment ID: I20110929000270 |
| Provider Name | Amy E Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427399617 PECOS PAC ID: 1254579543 Enrollment ID: I20130528000415 |
| Provider Name | Chelcia Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053702282 PECOS PAC ID: 6709105133 Enrollment ID: I20150506000204 |
| Provider Name | Ellery H Naghtin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750773586 PECOS PAC ID: 7012236235 Enrollment ID: I20150508001919 |
| Provider Name | Ashley Dossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194125245 PECOS PAC ID: 9436470317 Enrollment ID: I20150603002341 |
| Provider Name | Chelsey B Farless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891171724 PECOS PAC ID: 9133435415 Enrollment ID: I20150901002122 |
| Provider Name | Dena Lynn Kommer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174813240 PECOS PAC ID: 5193980928 Enrollment ID: I20151008002637 |
| Provider Name | Jeanie Doom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003291360 PECOS PAC ID: 7113236506 Enrollment ID: I20151026002647 |
| Provider Name | Diana Marie Hutchinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790289155 PECOS PAC ID: 5496018699 Enrollment ID: I20180423001958 |
| Provider Name | Tammy Dunaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669943502 PECOS PAC ID: 8527309509 Enrollment ID: I20190402000399 |
| Provider Name | William Stephen O'hearn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548753023 PECOS PAC ID: 8325470503 Enrollment ID: I20191108000186 |
| Provider Name | Bianca Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598310419 PECOS PAC ID: 5092047654 Enrollment ID: I20200501001361 |
| Provider Name | Disha R. Shah |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982919585 PECOS PAC ID: 3072739234 Enrollment ID: I20210615003137 |
| Provider Name | Ashley Gorrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609398452 PECOS PAC ID: 3779973623 Enrollment ID: I20211208000692 |
| Provider Name | Shanna G Burress |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336336098 PECOS PAC ID: 4082915319 Enrollment ID: I20220209001258 |
| Provider Name | Vincent Atsitty |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1598403164 PECOS PAC ID: 7618355041 Enrollment ID: I20230214001731 |
| Provider Name | Nancy Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922245141 PECOS PAC ID: 7810380474 Enrollment ID: I20231009000425 |
| Provider Name | William Adkins |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952414963 PECOS PAC ID: 5799086393 Enrollment ID: I20231204002662 |
Chester L. Crump Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1717 High St, Suite 2d, Hopkinsville, KY 42240 Phone: 270-885-6101 Fax: 270-885-3563 | |
Baptist Health Express Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Clinic Dr, Hopkinsville, KY 42240 Phone: 270-707-4262 Fax: 270-707-4280 | |
William E. Sweet, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1102 S Virginia St, Hopkinsville, KY 42240 Phone: 270-890-0440 Fax: 270-890-0449 | |
Generations Long Term Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 270 Burley Ave, Hopkinsville, KY 42240 Phone: 270-887-6767 Fax: 270-887-8344 | |
Jennie Stuart Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1717 High St, Suite 4b, Hopkinsville, KY 42240 Phone: 270-985-1376 Fax: 270-890-6036 | |
Convenient Care Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 W 18th St, Hopkinsville, KY 42240 Phone: 270-887-0100 Fax: 270-887-0425 |