Organization Active NPI

Dolphin Hills Family Healthcare

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1114596095
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DOLPHIN HILLS FAMILY HEALTHCARE
Practice address
410 N Mulberry St
Elizabethtown, KY 42701-1848
Phone
(270) 268-5036
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Melissa Anne Baumgardner, APRNNPI 1063970366
Title
Owner
Phone
(270) 268-5036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

410 N Mulberry St
Elizabethtown, KY 42701-1848

Mailing address

189 S Antelope CT
Rineyville, KY 40162-9696
Phone (270) 268-5036

Other practice location 1

3046 Dolphin Dr Ste 101
Elizabethtown, KY 42701-7114
Phone (270) 268-5036 ext. 85036

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210723000939 KY Part B Supplier - Clinic/Group Practice 5193128445 Receives reassigned benefits from 3 practitioners
Practice locations: Elizabethtown, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2228950Dolphin Hills Family Healthcare410 N Mulberry St, Elizabethtown, KY 42701Certificate of waiverJul 2, 2027

National Provider Directory

National Provider Directory

Locations

3046 Dolphin Dr
Ste 101
Elizabethtown, KY 42701
Phone 2702685036 ext. 85036

3046 Dolphin Dr
Ste 100
Elizabethtown, KY 42701
Phone (270) 982-1400

3046 Dolphin Dr
Ste E
Elizabethtown, KY 42701

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24513/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1114596095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 S ANTELOPE CT",
            "city": "RINEYVILLE",
            "state": "KY",
            "postal_code": "401629696",
            "telephone_number": "270-268-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011848",
            "telephone_number": "270-268-5036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3046 Dolphin Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427017114",
            "country_code": "US",
            "telephone_number": "270-268-5036 x85036",
            "fax_number": "833-992-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOLPHIN HILLS FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "BAUMGARDNER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-268-5036",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.