NPIMap

Organization Active NPI

Green River Area Development District

  • Supports Brokerage Agency
  • Owensboro, KY
National Provider Identifier
1003033085
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
Legal business name
GREEN RIVER AREA DEVELOPMENT DISTRICT
Practice address
300 Gradd Way
Owensboro, KY 42301-8696
Phone
(270) 926-4433
Fax
(270) 684-0714
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jiten Shah
Title
Executive Director
Phone
(270) 926-4433

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X KY
Developmentally Disabled Services Day Training Agency 251C00000X KY
Supports Brokerage Agency 251X00000X KY Primary

Addresses

Primary practice location

300 Gradd Way
Owensboro, KY 42301-8696

Mailing address

300 Gradd Way
Owensboro, KY 42301-8696
Phone (270) 926-4433

Other identifiers 3

IdentifierTypeStateIssuer
17000720MedicaidKY
33001371MedicaidKY
43996032MedicaidKY

Other names 1

  • Green River Area Agency on Aging Other name

National Provider Directory

National Provider Directory

Locations

300 Gradd Way
Owensboro, KY 42301
Phone (270) 926-4433

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1003033085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GRADD WAY",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423018696",
            "telephone_number": "270-926-4433",
            "fax_number": "270-684-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRADD WAY",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423018696",
            "telephone_number": "270-926-4433",
            "fax_number": "270-684-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN RIVER AREA DEVELOPMENT DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JITEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-926-4433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17000720",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33001371",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43996032",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green River Area Agency on Aging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.