Owensboro Health Medical Group, Inc
Organization Active NPI Clinical Medical Laboratory · Madisonville, KY
NPI 1043343536 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1043343536
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 200235 (KY)
- Legal business name
- OWENSBORO HEALTH MEDICAL GROUP, INC
- Practice address
- 510 Ruby Dr
Madisonville, KY 42431-2168 - Phone
- (270) 399-7900
- Fax
- (270) 399-7910
- NPI assigned
- Mar 13, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- OWENSBORO HEALTH INC
Authorized official
- Name
- Mr. Russell S Ranallo
- Title
- Secretary
- Phone
- (270) 417-4813
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 14
Practitioners 455
-
Syed Ali Abbas, MD
-
Ryan J Abel, MD
-
Ravi K. Alapati, MD
-
Pir Khalid Ali, M.D.
-
Nicole M Allen, APRN
-
Tara Allen, APRN
-
Darla M Alvey, APRN
-
Jin S. Amon, M.D.
-
Sarah Arnold, APRN
-
Mumen Ayyat, MD
-
Eric E Baker, MD
-
Adam C Barnard, PA-C
-
Tammy W Barton, P.T.
-
Tiffany Patterson Baugh, M.D.
-
Katherine Bean, APRN
-
Laura Marie Bearden, APRN, FNP-C
-
Callie Magdeline Bell, APRN
-
Daniel Keith Best, APRN
-
Justen L. Bickett, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D0909292 | Owensboro Health Madisonville Healthplex | Compliance | Apr 18, 2028 |
| 18D2062897 | Owensboro Health Madisonville Healthplex | Certificate of waiver | Jul 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070716000700 | KY | Part B Supplier - Independent Clinical Laboratory | 0648255034 |
1 other NPI on this enrollment Practice locations: Madisonville, KY |
National Provider Directory
- Tax ID family
- Mohammed Kaleemuddin MD
- Part of
- Owensboro Medical Health
Locations
25516 Network Pl
Chicago, IL 60673
601 Greene Dr
Greenville, KY 42345
Phone (270) 338-0600
815 E Parrish Ave
#230
Owensboro, KY 42303
Phone (270) 684-2984
1201 Pleasant Valley Rd
Fl 3
Owensboro, KY 42303
Phone (270) 417-5390
1201 Pleasant Valley Rd
Ste 202
Owensboro, KY 42303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 200235 | KY | Yes |
Addresses
Primary practice location
510 Ruby Dr
Madisonville, KY 42431-2168
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200235 | Other | KY | STATE LICENSURE NUMBER |
Other names
- Owensboro Health Madisonville Healthplex
- Owensboro Health Medical Group - MultiCare
Other providers in Madisonville, KY
- Ohio Valley Neurology LLC
- Heather Pendergraff Oldham
- Omni Visions, Inc
- Roger E Ordal
- Mark Allan Owen
- Owensboro Health Medical Group, Inc
- Owensboro Health Medical Group, Inc.
- Owensboro Health Medical Group, Inc.
- Owensboro Health Medical Group, Inc.
- Pain Management Centers of America, PSC
All providers in Madisonville, KY · Clinical Medical Laboratory in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.