Active NPI
Highlands Hospital Corp
- Cardiovascular Disease Physician
- Prestonsburg, KY
National Provider Identifier
1194818138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 100124
- Legal business name
- HIGHLANDS HOSPITAL CORP
- Practice address
- 5000 Ky Route 321
Prestonsburg, KY 41653-9113 - Phone
- (606) 886-8511
- Fax
- (606) 886-7761
- NPI assigned
- Oct 2, 2006
- Last updated
- Jun 13, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jack G Blackwell
- Title
- Cfo
- Phone
- (606) 886-7548
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 100124 | KY | |
| Physician Assistant | 363A00000X | NU | ||
| Nurse Practitioner | 363L00000X | NU | ||
| Family Nurse Practitioner | 363LF0000X | NU | ||
| Psychologist | 103T00000X | 100124 | KY | |
| Family Medicine Physician | 207Q00000X | NU | ||
| Internal Medicine Physician | 207R00000X | NU | ||
| Cardiovascular Disease Physician | 207RC0000X | 100124 | KY | Primary |
| Behavior Analyst | 103K00000X | NU |
Addresses
Primary practice location
5000 Ky Route 321
Prestonsburg, KY 41653-9113
Mailing address
PO Box 668
Prestonsburg, KY 41653-0668
Phone (606) 886-8511
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0327882 | Medicaid | OH | |
| 000000061959 | Other | KY | ANTHEM BC REF LAB |
| 000000054640 | Other | KY | ANTHEM BLUE CROSS PROVIDE |
| 01007137 | Medicaid | KY |
National Provider Directory
National Provider DirectoryLocations
313 West St
Paintsville, KY 41240
Phone (606) 788-6415
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Prestonsburg, KY
- NPI 1366477010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560384000000",
"number": "1194818138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416530668",
"telephone_number": "606-886-8511",
"fax_number": "606-886-7761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 KY ROUTE 321",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416539113",
"telephone_number": "606-886-8511",
"fax_number": "606-886-7761"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HIGHLANDS HOSPITAL CORP",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2019-06-13",
"status": "A",
"authorized_official_last_name": "BLACKWELL",
"authorized_official_first_name": "JACK",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "606-886-7548",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "KY",
"license": "100124",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "100124",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "KY",
"license": "100124",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0327882",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC REF LAB",
"identifier": "000000061959",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS PROVIDE",
"identifier": "000000054640",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01007137",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Prestonsburg, KY
- Highlands Center for Autism, Inc
- Highlands Heart and Vascular LLC
- Highlands Home Care, Inc.
- Highlands Home Care, Inc. (Highlands Home Health, Inc.)
- Highlands Hospital Corp (Highlands Regional Medical Center)
- Highlands Hospital Corp (HRMC Emergency Physicians)
- Highlands Medical Partners I LLC
- Highlands Medical Partners II
- Highlands Regional Medical Center
- Highlands Regional Medical Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.