Organization Active NPI

Highlands Hospital Corp

  • Cardiovascular Disease Physician
  • Prestonsburg, KY
National Provider Identifier
1194818138
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
100124 Issued in KY
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, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0327882MedicaidOH
000000061959OtherKYANTHEM BC REF LAB
000000054640OtherKYANTHEM BLUE CROSS PROVIDE
01007137MedicaidKY

National Provider Directory

National Provider Directory

Locations

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.

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

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.

Verify at the official NPI Registry.