NPIMap

Organization Active NPI

Pennyrile District Health Department

  • Public Health or Welfare Agency
  • Smithland, KY
National Provider Identifier
1205018652
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PENNYRILE DISTRICT HEALTH DEPARTMENT
Practice address
850 Cutoff Rd
Smithland, KY 42081-8914
Phone
(270) 928-3915
Fax
(270) 928-3915
NPI assigned
Nov 28, 2007
Organization subpart
Yes
Parent organization
PENNYRILE DISTRICT HEALTH DEPARTMENTAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. James M Tolley
Title
Public Health Director
Phone
(270) 388-9747

National Provider Directory

National Provider Directory
Tax ID family
Livingston Co Health de20 organizations share this tax ID, including this one
Part of
Livingston Co Health de

Other organizations with this tax ID 19

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

View all 19

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X KY Primary

Addresses

NPPES NPI Registry

Primary practice location

850 Cutoff Rd
Smithland, KY 42081-8914

Mailing address

PO Box 770
Eddyville, KY 42038-0770
Phone (270) 388-9747

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7100003660MedicaidKY

Other names 1

NPPES NPI Registry
  • South Livingston Co Mustang Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 28, 2007.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1205018652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "EDDYVILLE",
            "state": "KY",
            "postal_code": "420380770",
            "telephone_number": "270-388-9747",
            "fax_number": "270-388-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 CUTOFF RD",
            "city": "SMITHLAND",
            "state": "KY",
            "postal_code": "420818914",
            "telephone_number": "270-928-3915",
            "fax_number": "270-928-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNYRILE DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENNYRILE DISTRICT HEALTH DEPARTMENT",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "270-388-9747",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100003660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Livingston Co Mustang Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.