Look up the most recent NPI and PECOS records

Judith Lynn Cleary

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

700 Bob O Link Dr, Lexington, KY 40504-3756

PECOS Enrollment

Based on the most recent information from CMS, provider Judith Lynn Cleary does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1538254610
Provider Type
Individual
Full Name
Cleary, Judith Lynn
Credential
P.A.-C.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/4/2006
Last Updated
7/8/2007

Contact Information

Practice Location

700 Bob O Link Dr, Lexington, KY 40504-3756

(859) 258-8530

(859) 258-8515

Mailing Location

303 Woodcrest Dr, Nicholasville, KY 40356-9764

(859) 223-4709

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA641 Kentucky
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA641 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 95001772	Description Medicaid	Issuer Unlisted Kentucky

Judith Lynn Cleary

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kluemper, Mark J.

Kentucky Hand Center Psc

Senft, Sandra L

Bluegrass Oral & Maxillofacial Surgery Psc

Jones, Lou Ann