Active NPI
Owensboro Health Medical Group Inc
- Family Medicine Physician
- Central City, KY
National Provider Identifier
1083093017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- OWENSBORO HEALTH MEDICAL GROUP INC
- Practice address
- 101 Legion Dr
Suite 2
Central City, KY 42330-1496 - Phone
- (270) 754-7227
- Fax
- (270) 754-7230
- NPI assigned
- May 22, 2015
- Organization subpart
- Yes
- Parent organization
- OWENSBORO HEALTH INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John T Hackbarth Jr.
- Title
- Secretary
- Phone
- (270) 417-4813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
101 Legion Dr
Suite 2
Central City, KY 42330-1496
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070
Other names 1
- One Health Family Medicine Central City
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040621000818 | KY | Part B Supplier - Clinic/Group Practice | 0648255034 |
Receives reassigned benefits from 677 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Owensboro Medical Health
Locations
101 Legion Dr
Ste 2
Central City, KY 42330
Phone (270) 754-7227
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sleep Medicine (Family Medicine) Physician
- Owensboro, KY
- NPI 1235591983
Family Medicine
-
- Gastroenterology Physician
- Pittsfield, MA
- NPI 1508967456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1435622400000",
"number": "1083093017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23229",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423043229",
"telephone_number": "270-691-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LEGION DR",
"address_2": "SUITE 2",
"city": "CENTRAL CITY",
"state": "KY",
"postal_code": "423301496",
"telephone_number": "270-754-7227",
"fax_number": "270-754-7230"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OWENSBORO HEALTH MEDICAL GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "OWENSBORO HEALTH INC",
"enumeration_date": "2015-05-22",
"last_updated": "2015-06-30",
"status": "A",
"authorized_official_last_name": "HACKBARTH",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "270-417-4813",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "One Health Family Medicine Central City",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Central City, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.