NPIMap

Organization Active NPI

Methodist Health, Inc.

Doing business as Methodist Family Medicine

  • Family Nurse Practitioner
  • Sebree, KY
National Provider Identifier
1013192293
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3003510 Issued in KY
Legal business name
METHODIST HEALTH, INC.
Doing business as
Methodist Family Medicine
Methodist Family Medicine of Sebree
Practice address
47 W. Webster Street
Sebree, KY 42455-0426
Phone
(270) 835-7541
Fax
(270) 835-7802
NPI assigned
Jan 7, 2008
Last updated
Jul 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Mr. Benny J Nolen
Title
Ceo
Phone
(270) 827-7500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 39647 KY
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 3003510 KY Primary

Addresses

Primary practice location

47 W. Webster Street
Sebree, KY 42455-0426

Mailing address

PO Box 638706
Cincinnati, OH 45263-8706
Phone (270) 827-7558

Other identifiers 1

IdentifierTypeStateIssuer
7100026620MedicaidKY

Other names 2

  • Methodist Family Medicine Doing business as
  • Methodist Family Medicine of Sebree Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000875 KY Part B Supplier - Clinic/Group Practice 4981508454 Receives reassigned benefits from 127 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Morganfield, KY; Henderson, KY; Dixon, KY

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1013192293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638706",
            "telephone_number": "270-827-7558",
            "fax_number": "270-827-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 W. WEBSTER STREET",
            "city": "SEBREE",
            "state": "KY",
            "postal_code": "424550426",
            "telephone_number": "270-835-7541",
            "fax_number": "270-835-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "BENNY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-827-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "39647",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3003510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100026620",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Methodist Family Medicine of Sebree",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebree, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.