NPIMap

Organization Active NPI

Baptist Health Medical Group Inc

  • Gastroenterology Physician
  • Louisville, KY
National Provider Identifier
1093071128
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BAPTIST HEALTH MEDICAL GROUP INC
Practice address
3950 Kresge Way
Suite 207
Louisville, KY 40207-4637
Phone
(502) 893-0220
Fax
(502) 893-0563
NPI assigned
Apr 3, 2012
Last updated
Jul 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Danyel Clay
Title
VP Revenue Cycle
Phone
(502) 253-4911

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

3950 Kresge Way
Suite 207
Louisville, KY 40207-4637

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 253-4911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000503 KY Part B Supplier - Clinic/Group Practice 5597867184 Receives reassigned benefits from 1,548 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 40

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

View all 40

National Provider Directory

National Provider Directory
Tax ID family
Louisville Cardiology Group59 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

1023 New Moody Ln
Ste 10
La Grange, KY 40031
Phone (502) 222-6008

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1093071128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-253-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY",
            "address_2": "SUITE 207",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-893-0220",
            "fax_number": "502-893-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "DANYEL",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "502-253-4911"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.