NPIMap

Organization Active NPI

Green Valley Hospital Medicine Physicians, LLC

  • Internal Medicine Physician
  • Paducah, KY
National Provider Identifier
1215604236
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GREEN VALLEY HOSPITAL MEDICINE PHYSICIANS, LLC
Practice address
1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone
(271) 444-2444
NPI assigned
Aug 26, 2021
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Allyson Wirtz
Title
Provider Enrollment
Phone
(337) 581-6920

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1530 Lone Oak Rd
Paducah, KY 42003-7901

Mailing address

400 Galleria Pkwy SE Ste 960
Atlanta, GA 30339-5980
Phone (404) 500-8147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211203000205 AZ Part B Supplier - Clinic/Group Practice 3779973839 Receives reassigned benefits from 21 practitioners
Practice locations: Green Valley, AZ
O20231115001741 KY Part B Supplier - Clinic/Group Practice 3779973839 Receives reassigned benefits from 49 practitioners
Practice locations: Paducah, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 73

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.

View all 73

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1215604236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GALLERIA PKWY SE STE 960",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395980",
            "telephone_number": "404-500-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037901",
            "telephone_number": "271-444-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY HOSPITAL MEDICINE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "WIRTZ",
        "authorized_official_first_name": "ALLYSON",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "337-581-6920"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.