Provider Demographics
NPI:1932391976
Name:PYMA MEDICAL PLLC
Entity Type:Organization
Organization Name:PYMA MEDICAL PLLC
Other - Org Name:PHYSICIANS EXPRESS CARE BILLING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:PHILPOT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-878-1181
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0910
Mailing Address - Country:US
Mailing Address - Phone:606-878-1181
Mailing Address - Fax:606-878-1267
Practice Address - Street 1:93 C V B DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1096
Practice Address - Country:US
Practice Address - Phone:606-878-1181
Practice Address - Fax:606-878-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363L00000X
KY3007337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100452580Medicaid
KY18D1050402OtherCLIA
KY7100185110-NP GRPMedicaid