Individual provider Active NPI

Mark A Risen, DPM

  • Primary Podiatric Medicine Podiatrist
  • Campbellsville, KY
National Provider Identifier
1174571004
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
00216 Issued in KY
Practice address
1003 Old Greensburg Rd
Campbellsville, KY 42718-2571
Phone
(270) 433-5806
Fax
(270) 433-2443
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00216 KY
Primary Podiatric Medicine Podiatrist 213EP1101X 00216 KY Primary

Addresses

Primary practice location

1003 Old Greensburg Rd
Campbellsville, KY 42718-2571

Mailing address

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

Other practice location 1

138 Campbellsville Byp
Campbellsville, KY 42718-8843
Phone (270) 433-5806

Other practice location 2

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-6791

Other practice location 3

810 Jamestown St
Columbia, KY 42728-1010
Phone (270) 384-4764

Other practice location 4

1301 N Race St
Glasgow, KY 42141-3483
Phone (270) 651-4444

Other identifiers 1

IdentifierTypeStateIssuer
80002165MedicaidKY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000061 KY Practitioner - Podiatry 3577456110 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Physicians and Surgeons (Iowa), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T J Health Columbia IncGroup PAC ID 7113224783, shared by 10 NPIs, 43 clinicians
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians
Adair County Hospital DistrictGroup PAC ID 3577474667, 20 clinicians

Practice addresses (Care Compare)

1003 Old Greensburg Rd
Campbellsville, KY 42718-2571
Phone (270) 789-4342

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111

810 Jamestown St
Columbia, KY 42728-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as individual
Quality
73.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.9 of 100Reported as group
Quality
85.93
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue124
Removal of skin lesions15
Removal of nail tissue586
Removal or shaving of skin growth56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00216KYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
T J Health Columbia Inc CurrentSince Feb 28, 2020 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Health Columbia Inc Podiatrist CurrentSince Jul 7, 2025 Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Health Columbia Inc CurrentSince Feb 28, 2020 Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Samson Community Hospital Current Accepting new patients
Mark a Risen, DPM, Podiatrist CurrentSince Sep 16, 2002 Accepting new patients
T J Samson Community Hospital Podiatrist CurrentSince Jul 7, 2025 Accepting new patients
T J Samson Community Hospital Past Accepting new patients

Locations

138 Campbellsville Byp
Ste 4
Campbellsville, KY 42718
Phone (270) 789-4342

1003 Old Greensburg Rd
Campbellsvlle, KY 42718
Phone (270) 465-0060

810 Jamestown St
Columbia, KY 42728
Phone (270) 384-4764

901 Wellness Way
Columbia, KY 42728
Phone (270) 384-4753

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

1216A N Race St
Glasgow, KY 42141
Phone (270) 651-8348

Organizations & group practices 11

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

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1174571004",
    "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": "1003 OLD GREENSBURG RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182571",
            "telephone_number": "270-433-5806",
            "fax_number": "270-433-2443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 Campbellsville Byp",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "427188843",
            "country_code": "US",
            "telephone_number": "270-433-5806",
            "fax_number": "270-433-2443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 N L Rogers Wells Blvd",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421411300",
            "country_code": "US",
            "telephone_number": "270-651-6791",
            "fax_number": "270-659-5850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Jamestown St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "KY",
            "postal_code": "427281010",
            "country_code": "US",
            "telephone_number": "270-384-4764",
            "fax_number": "270-384-2828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 N Race St",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421413483",
            "country_code": "US",
            "telephone_number": "270-651-4444",
            "fax_number": "270-651-4892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RISEN",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "00216",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "KY",
            "license": "00216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002165",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.