Kentuckyone Health Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Lexington, KY
NPI 1205101458 · NPPES record last updated Aug 14, 2025
Key facts
- NPI
- 1205101458
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- KENTUCKYONE HEALTH MEDICAL GROUP, INC.
- Practice address
- 1401 Harrodsburg Rd
Lexington, KY 40504-3751 - Phone
- (606) 330-7835
- Fax
- (606) 330-7825
- NPI assigned
- Mar 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Carmel Jones
- Title
- President
- Phone
- (859) 313-1713
Other NPIs on the same Medicare enrollment 2
Practitioners 50
-
Majdi Lagili Al Dliw, M.D
-
Mohamed Shtiwi Ayan, MBBCH, MD
-
Amy Elizabeth Baker, D.O
-
Richard Alan Blake, M.D.
-
Elizabeth Shawn Campbell, M.D.
-
Yousef Darrat, MD
-
Vincent Angelo Depalma, D.O.
-
Jocelyn Elhalawany, APRN
-
Julianne Z Ewen, ARNP
-
Carla Deanne Gilbert, APRN
-
Fred Park Hadley, MD
-
Alexander Hernandez, M.D.
-
Tyler B. Holley, M.D.
-
Robin R House, APRN NP
-
Justin Dale Johnson, M.D.
-
Phyo P Kyaw, M.D
-
Steve S Lin, MD
-
Maria P. Mendoza, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031204000080 | KY | Part B Supplier - Clinic/Group Practice | 8820993702 |
Receives reassigned benefits from 284 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
211 Fountain Ct
Ste 220
Lexington, KY 40509
Phone (859) 629-7265
211 Fountain Ct
Ste 210
Lexington, KY 40509
Phone (859) 629-7265
227 Falcon Dr
Ste 101
Mt Sterling, KY 40353
Phone (859) 497-5135
227 Falcon Dr
Ste 104
Mt Sterling, KY 40353
Phone (859) 497-5459
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Social Worker |
104100000X | |||
| Family Medicine Physician |
207Q00000X | KY | Yes | |
| Adolescent Medicine (Family Medicine) Physician |
207QA0000X | |||
| Adult Medicine Physician |
207QA0505X | |||
| Internal Medicine Physician |
207R00000X | KY | ||
| Adolescent Medicine (Internal Medicine) Physician |
207RA0000X | KY | ||
| Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician |
2081H0002X | KY | ||
| Psychiatry Physician |
2084P0800X | |||
| Physician Assistant |
363A00000X | KY | ||
| Nurse Practitioner |
363L00000X | KY |
Addresses
Primary practice location
1401 Harrodsburg Rd
Lexington, KY 40504-3751
Mailing address
PO Box 936
London, KY 40743-0936
Phone (606) 330-7835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200434820A | Medicaid | IN | |
| 000000060604 | Other | KY | ANTHEM GROUP |
| 7100161650 (FRAZIER) | Medicaid | KY | |
| 7100200840 (LCSW) | Medicaid | KY | |
| 78904851 (NP) | Medicaid | KY | |
| 7100200890 (PA) | Medicaid | KY | |
| 7100200880 (CRNA) | Medicaid | KY | |
| 7100200870 (MD) | Medicaid | KY |
Other names
- CHI Saint Joseph Medical Group
Other providers in Lexington, KY
- Kentucky Sports Medicine Clinic
- Kentucky Technical Services, PSC
- Kentucky Therapy Solutions, LLC
- Kentucky Urgent Care Walk-in Clinic
- Kentuckyone Health Medical Group, Inc.
- Kentuckyone Health Medical Group, Inc.
- Jill C Keogh
- Alexandra Paige Keough
- Christian Kephart
- Joseph Kephart
All providers in Lexington, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.