Individual provider Active NPI

Christopher Ray Hodges, PAC

  • Physician Assistant
  • Paducah, KY
National Provider Identifier
1184615080
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA069 Issued in KY
Practice address
2603 Kentucky Ave
Suite 304
Paducah, KY 42003-3814
Phone
(270) 415-4800
Fax
(270) 415-4801
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA069 KY Primary

Addresses

Primary practice location

2603 Kentucky Ave
Suite 304
Paducah, KY 42003-3814

Mailing address

2605 Kentucky Ave
Suite 306
Paducah, KY 42003-3800
Phone (270) 415-7653

Other identifiers 1

IdentifierTypeStateIssuer
95001392MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chodges7208@bhkydirect.com

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
I20101026000813 KY Practitioner - Physician Assistant 2062460983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2603 Kentucky Ave
Suite 304
Paducah, KY 42003-3829
Phone (270) 415-4800

2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3801
Phone (270) 441-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA069KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Jan 4, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 4, 2015 Accepting new patients
Southern Orthopedic Associates SC Physician Assistant Past Accepting new patients
Surgical Group PSC Past Accepting new patients
Vascular Specialists,PLLC Past Accepting new patients
Purchase Pain Managment LLC Physician Assistant Past Accepting new patients
Neurosurgical Associates of Western Kentucky, PSC Past Accepting new patients
Western Baptist Medical Ventures, Inc. Past Accepting new patients

Locations

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2603 Kentucky Ave
Ste 404
Paducah, KY 42003
Phone (270) 443-6472

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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 1

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1184615080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-7653",
            "fax_number": "270-575-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 KENTUCKY AVE",
            "address_2": "SUITE 304",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033814",
            "telephone_number": "270-415-4800",
            "fax_number": "270-415-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001392",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chodges7208@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2603 Kentucky Ave",
            "address_2": "Suite 304",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.