NPIMap

Organization Active NPI

Jennie Stuart Medical Center

  • Family Medicine Physician
  • Hopkinsville, KY
National Provider Identifier
1164589842
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JENNIE STUART MEDICAL CENTER
Practice address
320 W 18TH St
Hopkinsville, KY 42240-1965
Phone
(270) 887-0100
Fax
(270) 887-0425
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donna Russell
Title
Director Patient Financial Services
Phone
(270) 887-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

320 W 18TH St
Hopkinsville, KY 42240-1965

Mailing address

PO Box 2400
Hopkinsville, KY 42241-2400
Phone (270) 887-0100

Other identifiers 2

IdentifierTypeStateIssuer
6593432500MedicaidKY
000000212362OtherKYBLUE CROSS PROFESSIONAL

Other names 1

  • Convenient Care Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jennie Stuart Medical C17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164589842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422412400",
            "telephone_number": "270-887-0100",
            "fax_number": "270-887-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 18TH ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401965",
            "telephone_number": "270-887-0100",
            "fax_number": "270-887-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIE STUART MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIRECTOR PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "270-887-0100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6593432500",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROFESSIONAL",
            "identifier": "000000212362",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convenient Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.