Individual provider Active NPI

Robert A Payne, APRN

  • Gerontology Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1114379435
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
3010647 Issued in KY
Practice address
2801 New Hartford Rd
Owensboro, KY 42303-1320
Phone
(270) 683-3720
Fax
(270) 686-7331
NPI assigned
Jul 11, 2016
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28199081A IN
Registered Nurse 163W00000X 1087636 KY
Gerontology Nurse Practitioner 363LG0600X 3010647 KY Primary

Addresses

Primary practice location

2801 New Hartford Rd
Owensboro, KY 42303-1320

Mailing address

2801 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 683-3720

Other identifiers 2

IdentifierTypeStateIssuer
201395620MedicaidIN
7100418340MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpayne65927@direct.owensborohealth.org Owensboro Health Medical Group, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005002401 KY Practitioner - Nurse Practitioner 8325336472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

2211 Mayfair Dr
Owensboro, KY 42301-4569

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28199081AINMDRegistered Nurse
1087636KYMDRegistered Nurse
3010647KYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rpayne65927@direct.owensborohealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1114379435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NEW HARTFORD RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-683-3720",
            "fax_number": "270-686-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NEW HARTFORD RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-683-3720",
            "fax_number": "270-686-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28199081A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1087636",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "3010647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201395620",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100418340",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpayne65927@direct.owensborohealth.org",
            "affiliation": "Y",
            "affiliationName": "Owensboro Health Medical Group, Inc",
            "address_1": "2801 New Hartford Rd",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423031320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.