NPIMap

Organization Active NPI

T J Samson Community Hospital

Doing business as T J Samson Family Medicine Center

  • Family Medicine Physician
  • Glasgow, KY
National Provider Identifier
1093752040
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
T J SAMSON COMMUNITY HOSPITAL
Doing business as
T J Samson Family Medicine Center
Practice address
1325 N Race St
Glasgow, KY 42141-3454
Phone
(270) 651-4797
Fax
(270) 651-4818
NPI assigned
May 31, 2006
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
T J REGIONAL HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Neil Thornbury
Title
Ceo
Phone
(270) 651-4159

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1325 N Race St
Glasgow, KY 42141-3454

Mailing address

PO Box 645996
Cincinnati, OH 45264-5996
Phone (270) 651-4444

Other identifiers 2

IdentifierTypeStateIssuer
65930273MedicaidKY
7100330260MedicaidKY

Other names 1

  • T J Samson Family Medicine Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318001777 KY Part B Supplier - Clinic/Group Practice 0648182600 Receives reassigned benefits from 330 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glasgow, KY; Horse Cave, KY; Jamestown, KY; Lexington, KY; Louisville, KY; Monticello, KY; Tompkinsville, KY; Ashland, KY…

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
T J Samson Community Hosp16 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

Locations

1325 N Race St
Glasgow, KY 42141
Phone (270) 651-4797

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1093752040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645996",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452645996",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413454",
            "telephone_number": "270-651-4797",
            "fax_number": "270-651-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T J SAMSON COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "T J REGIONAL HEALTH INC",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "THORNBURY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-651-4159"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65930273",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100330260",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T J Samson Family Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.