NPIMap

Organization Active NPI

Baptist Health Deaconess Medical Group Inc

  • Rural Health Clinic/Center
  • Madisonville, KY
National Provider Identifier
1144804311
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BAPTIST HEALTH DEACONESS MEDICAL GROUP INC
Practice address
800 Hospital Dr FL 2
Madisonville, KY 42431-1658
Phone
(270) 326-3900
Fax
(270) 326-3905
NPI assigned
May 12, 2021
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Valarie Howard
Title
Executive Director Revenue Cycle
Phone
(270) 326-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

800 Hospital Dr FL 2
Madisonville, KY 42431-1658

Mailing address

5200 Commerce Crossings Dr FL 3
Louisville, KY 40229-2182
Phone (502) 253-4911

Other names 1

  • MADISONVILLE OB RHC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210810000993 KY Part B Supplier - Clinic/Group Practice 6103220330 Receives reassigned benefits from 322 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Princeton, KY; Dawson Springs, KY; Powderly, KY; Madisonville, KY; Hopkinsville, KY; Clay, KY
O20211208000553 KY Part A Provider - Rural Health Clinic 6103220330 Practice locations: Madisonville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144804311. Details of each certification follow.

Rural health clinic certification: CCN B03825

Legal name
BAPTIST HEALTH DEACONESS MEDICAL GROUP INC
Doing business as
MADISONVILLE OB RHC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 28, 2020
Last certification
Oct 28, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 2021 in KY
Enrollment address
800 Hospital Dr
FL 2
Madisonville, KY 42431-1658

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Baptist Health Deaconess, LLC Organization, Louisville, KY LLC, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%
Marc J Florence Individual Corporate DirectorDirector Sep 1, 2021
Richard Carrico Individual Corporate DirectorDirector Apr 12, 2023
Lynn C Lingafelter Individual Corporate DirectorDirector Sep 1, 2021
Danyel D Clay Individual Corporate OfficerVice President Sep 1, 2021
W-2 Managing EmployeeVice President Sep 1, 2021
Isaac J Myers Individual Corporate DirectorDirector Sep 1, 2021
Joseph W Prather Individual Corporate OfficerChief Strategy & Marketing Officer Sep 1, 2021
Valarie Howard Individual Corporate OfficerCfo May 1, 2025
Shawn W McCoy Individual Corporate DirectorDirector Sep 1, 2021
Patrick Falvey Individual Corporate OfficerChief Operating Officer Sep 1, 2021
James Porter Individual Corporate DirectorDirector Sep 1, 2021

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Sep 1, 2021 Change of OwnershipThis provider was the buyer BHMG Womens CareCCN B03825, KY, NPI 1265072946

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1144804311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOSPITAL DR FL 2",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311658",
            "telephone_number": "270-326-3900",
            "fax_number": "270-326-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH DEACONESS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "270-326-3900"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MADISONVILLE OB RHC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MADISONVILLE OB RHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.