Paul C Pedersen General Practice
4071 Tates Creek Centre Dr, Suite 100, Lexington, KY 40517-3062


Paul C Pedersen is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1003892720. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 6406835560. The medical credential is MD. The primary specialty is GENERAL PRACTICE. The organization is BAPTIST HEALTH MEDICAL GROUP INC. The address is 4071 Tates Creek Centre Dr, Suite 100, Lexington, KY 40517-3062. The zip code is 40517.


Paul C Pedersen · 4071 Tates Creek Centre Dr, Suite 100, Lexington, KY 40517-3062

Nation Provider ID 1003892720
PAC ID by PECOS 6406835560
Professional Enrollment ID I20040809000698
Last Name PEDERSEN
First Name PAUL
Middle Name C
Gender M
Credential MD
Medical School Name OTHER
Graduation Year 1992
Primary Specialty GENERAL PRACTICE
Primary Specialty BAPTIST HEALTH MEDICAL GROUP INC
Phone Number 8592733888
Group Practice PAC ID 5597867184
Number of Group Practice Members 1239
Address 4071 TATES CREEK CENTRE DR
SUITE 100
LEXINGTON, KY 405173062
Claims Based Hospital Affiliation Claim Control Number (CCN): 180080
Legal Business Name: BAPTIST HEALTH CORBIN
Claims Based Hospital Affiliation Claim Control Number (CCN): 181328
Legal Business Name: BARBOURVILLE ARH HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 180011
Legal Business Name: SAINT JOSEPH LONDON
Claims Based Hospital Affiliation Claim Control Number (CCN): 180021
Legal Business Name: PINEVILLE COMMUNITY HOSPITAL
Professional accepts Medicare Assignment Y
Report Quality Measures Y

subpremise: 100
street_number: 4071
route: Tates Creek Centre Drive (Tates Creek Centre Dr)
neighborhood, political: Belleau Woods
locality, political: Lexington
admin_level_2, political: Fayette County
admin_level_1, political: Kentucky (KY)
country, political: United States (US)
postal_code: 40517
types : subpremise
latitude: 37.9737204
longitude: -84.4996424
latlng: (37.9737204, -84.4996424)


Baptist Health Medical Group Inc · Medicare Physician

Name Address Specialty
Melissa Hale 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 PHYSICIAN ASSISTANT
Gwendolyn Crawford 3900 Kresge Way, Louisville, KY 40207-4683 PHYSICAL THERAPY
Lori Spraggs 900 Hospital Dr, Madisonville, KY 42431-1644 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Donna Schwartz 210 Bevins Ln, Georgetown, KY 40324-6127 NURSE PRACTITIONER
Terry Weiss 3900 Kresge Way, Louisville, KY 40207-4683 FAMILY PRACTICE
Satish Shah 900 Hospital Dr, Madisonville, KY 42431-1644 RADIATION ONCOLOGY
Kent Kessler 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 GENERAL SURGERY
Robert Zoller 3900 Kresge Way, Louisville, KY 40207-4683 OBSTETRICS/GYNECOLOGY
Kathryn Baucom 3900 Kresge Way, Louisville, KY 40207-4683 CLINICAL SOCIAL WORKER
Kristy Chappell 2603 Kentucky Ave, Paducah, KY 42003-3829 FAMILY PRACTICE
Shellie Thompson 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 INTERNAL MEDICINE
Randall Dalton 800 Hospital Dr, Madisonville, KY 42431-1658 OTOLARYNGOLOGY
Cady Knight 3900 Kresge Way, Louisville, KY 40207-4683 NURSE PRACTITIONER
Syed Raza 1373 E State Rd, Madison, IN 47250-7328 CARDIOVASCULAR DISEASE (CARDIOLOGY)
Diane Bielefeld 4003 Kresge Way, Louisville, KY 40207-4652 NURSE PRACTITIONER
James Eckman 3900 Kresge Way, Louisville, KY 40207-4683 RADIATION ONCOLOGY
Shannon Roberts 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 INTERNAL MEDICINE
Sandra Shuffett 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 DIAGNOSTIC RADIOLOGY
Clayton Barclay 10216 Taylorsville Rd, Louisville, KY 40299-3617 EMERGENCY MEDICINE
Richard Byers 3900 Kresge Way, Louisville, KY 40207-4683 NURSE PRACTITIONER

Zip 40517 · Medicare Physician

Name Address Specialty
Angela Pennington 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 NURSE PRACTITIONER
Anna Gerard 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 PHYSICIAN ASSISTANT
Ivan Morrin 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 FAMILY PRACTICE
Joseph Pullekines 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 ORTHOPEDIC SURGERY
Gerald Eichhorn 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 NEUROLOGY
Christina Curzon 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 FAMILY PRACTICE
Timothy Mccullough 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 PHYSICIAN ASSISTANT
Vicki Hisle 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 NURSE PRACTITIONER
Angela Mudd 3150 Custer Dr, Lexington, KY 40517-4010 CLINICAL SOCIAL WORKER
Raymond Hackett 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 UROLOGY
Robin Smith 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 NURSE PRACTITIONER
Kimberly Pruitt 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 NURSE PRACTITIONER
Abby Childers 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 NURSE PRACTITIONER
Steven Kiefer 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 NEUROSURGERY
Richard Austin 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 PHYSICIAN ASSISTANT
Irida Molla 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 INTERNAL MEDICINE
Adam Adkins 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 PHYSICIAN ASSISTANT
Michael Rukavina 4071 Tates Creek Centre Dr, Lexington, KY 40517-3062 INTERVENTIONAL CARDIOLOGY
Aaron Hesselson 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 CARDIAC ELECTROPHYSIOLOGY
Sandeep Duggal 4071 Tates Creek Centre Dr, Lexington, KY 40517-3094 CARDIAC ELECTROPHYSIOLOGY