NPIMap

Individual provider Active NPI

David J Hays, MD

  • Family Medicine Physician
  • London, KY
National Provider Identifier
1215929997
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19661 Issued in KY
Practice address
2659 N Laurel Rd
London, KY 40741-9075
Phone
(606) 843-6195
Fax
(606) 843-6222
NPI assigned
Aug 18, 2005
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 19661 KY
Family Medicine Physician 207Q00000X 19661 KY Primary

Addresses

Primary practice location

2659 N Laurel Rd
London, KY 40741-9075

Mailing address

PO Box 495
East Bernstadt, KY 40729-0495
Phone (606) 843-6195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20091120000073 KY Practitioner - Family Practice 6305740424 Reassigns benefits to 1 organization
Receives reassigned benefits from 7 practitioners
Practice locations: Annville, KY; East Bernstadt, KY; Manchester, KY; McKee, KY
O20101129001093 KY Part A Provider - Rural Health Clinic 6901092212 Practice locations: McKee, KY
O20120113000150 KY Part A Provider - Rural Health Clinic 5698942753 Practice locations: Annville, KY
O20171002003590 KY Part A Provider - Rural Health Clinic 5698942753 Practice locations: Manchester, KY
O20230202000326 KY Part A Provider - Rural Health Clinic 6901092212 Practice locations: London, KY

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1215929997. Details of each certification follow.

Rural health clinic certification: CCN 183923

Legal name
DAVID HAYS
Doing business as
MCKEE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 16, 2004
Last certification
Aug 16, 2017
Ownership / control type
1A
Most recent change of ownership
Jul 10, 2009 (1 total)
Organization structure
Sole ProprietorProprietary
Enrollment address
25 Hwy 290 Campbell
Drug BLDG
McKee, KY 40447-0757

Rural health clinic certification: CCN 183955

Legal name
DAVID J HAYS
Doing business as
ANNVILLE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2007
Last certification
Sep 17, 2014
Ownership / control type
1A
Most recent change of ownership
Jul 10, 2009 (1 total)
Organization structure
Sole ProprietorProprietary
Enrollment address
78 Hwy 3444
Ste 1
Annville, KY 40402-0398

Rural health clinic certification: CCN 183967

Legal name
DAVID J HAYS
Doing business as
BURNING SPRINGS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 10, 2009
Last certification
Jul 5, 2016
Ownership / control type
1B
Most recent change of ownership
Aug 21, 2012 (1 total)
Organization structure
Sole ProprietorProprietary
Incorporated
Jul 1, 2009 in KY
Enrollment address
11901 N Highway 421
Manchester, KY 40962-4859

Rural health clinic certification: CCN B03928

Legal name
DAVID HAYS
Doing business as
EAST BERNSTADT MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 21, 2023
Last certification
Aug 21, 2023
Ownership / control type
1A
Organization structure
Sole ProprietorProprietary
Enrollment address
2659 N Laurel Rd
London, KY 40741-9075

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0322676Annville Medical Clinic78 Hwy 3444, Annville, KY 40402ComplianceNov 10, 2027

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11901 N Hwy 421
Manchester, KY 40962-4859
Phone (606) 598-2706

2659 N Laurel Rd
East Bernstadt, KY 40729-0495
Phone (606) 843-6195

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19661KYMDRural Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
East Bernstadt Medical Clinic PLLC Family Medicine CurrentSince Jul 10, 2009 Accepting new patients
East Bernstadt Medical Clinic PLLC Family Medicine PastSince Jan 1, 1990 Accepting new patients
East Bernstadt Medical Clinic PLLC Family Medicine PastSince Jan 1, 1990 Accepting new patients
East Bernstadt Medical Clinic PLLC Family Medicine PastSince Jan 1, 1990 Accepting new patients
Three Stores Inc PastSince Jul 1, 2010 Accepting new patients
LP Annville, LLC Past Accepting new patients
Anand PSC Past Accepting new patients

Locations

11901 N Highway 421
Manchester, KY 40962
Phone (606) 598-2706

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carla Johnson Individual W-2 Managing EmployeeBilling Manager Feb 16, 2004 100%
W-2 Managing EmployeeBilling/Credentialing Manager Nov 1, 2012
W-2 Managing EmployeeBilling/Credentialing Manager Jul 3, 1999
W-2 Managing EmployeeBilling/Credentialing Manager Aug 1, 2022 100%
David J Hays Individual 5% Or Greater Direct Ownership InterestMD/Owner Jul 10, 2009 100%
Corporate Director Jul 1, 2009 100%
W-2 Managing EmployeeMD; Jul 10, 2009 100%
5% Or Greater Direct Ownership InterestSole Proprietor Jul 10, 2009 100%
Corporate DirectorOwner Aug 30, 1998 100%
Operational/Managerial ControlOwner Aug 30, 1998 100%
5% Or Greater Direct Ownership Interest Aug 21, 2012 100%
Corporate DirectorPhysician/Owner Jul 1, 1980
5% Or Greater Direct Ownership Interest Aug 1, 2022

Practitioners & affiliated clinicians

Practitioners 7

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.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1215929997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "EAST BERNSTADT",
            "state": "KY",
            "postal_code": "407290495",
            "telephone_number": "606-843-6195",
            "fax_number": "606-843-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 N LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419075",
            "telephone_number": "606-843-6195",
            "fax_number": "606-843-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYS",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "19661",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "19661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.