NPIMap

Organization Active NPI

Green River District Health Dept

  • Home Health Agency
  • Owensboro, KY
National Provider Identifier
1063409266
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
150007 Issued in KY
Legal business name
GREEN RIVER DISTRICT HEALTH DEPT
Practice address
1600 Breckenridge St
Owensboro, KY 42303-1055
Phone
(270) 686-8123
Fax
(270) 683-1119
NPI assigned
Oct 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Mrs. Deborah Fillman, MS, RD, LD, CDE
Title
Public Health Director
Phone
(270) 686-7747

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 150007 KY Primary
Early Intervention Provider Agency 252Y00000X 150007 KY

Addresses

Primary practice location

1600 Breckenridge St
Owensboro, KY 42303-1055

Mailing address

PO Box 309
Owensboro, KY 42302-0309
Phone (270) 686-8123

Other identifiers 1

IdentifierTypeStateIssuer
3400251900MedicaidKY

Other names 1

  • Green River District Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060629000211 KY Part A Provider - Home Health Agency 5395642458 Practice locations: Owensboro, KY

Home health agency certification: CCN 187053

Legal name
GREEN RIVER DISTRICT HEALTH DEPT
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1974
Last certification
Oct 18, 2019
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
1600 Breckenridge St
Owensboro, KY 42303-1055
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Green River District HHACCN 187053
Ownership
Government Operated
Certified
Jul 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Green River District Health16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Clayton Horton Individual Corporate Director Aug 1, 2017
W-2 Managing Employee Aug 1, 2017
Angel Thompson Individual W-2 Managing Employee Jan 30, 2012
Green River District Health Dept Organization, Owensboro, KY Other Jul 1, 1974 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1063409266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423020309",
            "telephone_number": "270-686-8123",
            "fax_number": "270-683-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031055",
            "telephone_number": "270-686-8123",
            "fax_number": "270-683-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN RIVER DISTRICT HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "FILLMAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "270-686-7747",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, RD, LD, CDE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KY",
            "license": "150007",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "150007",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400251900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green River District Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.