David J Hays, MD
Individual provider Active NPI Family Medicine Physician · London, KY
NPI 1215929997 · NPPES record last updated Jun 1, 2016
Key facts
- NPI
- 1215929997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 19661 (KY)
- Practice address
- 2659 N Laurel Rd
London, KY 40741-9075 - Phone
- (606) 843-6195
- Fax
- (606) 843-6222
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 7
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D0322676 | Annville Medical Clinic | Compliance | Nov 10, 2027 |
Medicare Care Compare profile
- 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
- Vna Health at Home 1
- Adventhealth Home Health
- Professional Home Health Care, Inc
- Saint Joseph London
- Baptist Health Corbin
- AdventHealthManchester
- Signature Healthcare at Jackson Manor Rehab and We
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
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 Proprietor · Proprietary
- 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 Proprietor · Proprietary
- 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 Proprietor · Proprietary
- 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 Proprietor · Proprietary
- Enrollment address
- 2659 N Laurel Rd
London, KY 40741-9075
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Carla Johnson |
W-2 Managing Employee |
Feb 16, 2004 | 100% |
| W-2 Managing Employee |
Nov 1, 2012 | ||
| W-2 Managing Employee |
Jul 3, 1999 | ||
| W-2 Managing Employee |
Aug 1, 2022 | 100% | |
| David J Hays |
5% Or Greater Direct Ownership Interest |
Jul 10, 2009 | 100% |
| Corporate Director | Jul 1, 2009 | 100% | |
| W-2 Managing Employee |
Jul 10, 2009 | 100% | |
| 5% Or Greater Direct Ownership Interest |
Jul 10, 2009 | 100% | |
| Corporate Director |
Aug 30, 1998 | 100% | |
| Operational/Managerial Control |
Aug 30, 1998 | 100% | |
| 5% Or Greater Direct Ownership Interest | Aug 21, 2012 | 100% | |
| Corporate Director |
Jul 1, 1980 | ||
| 5% Or Greater Direct Ownership Interest | Aug 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bernstadt Medical Clinic PLLC | Family Medicine | Current |
Accepting new patients |
| East Bernstadt Medical Clinic PLLC | Family Medicine | Past |
Accepting new patients |
| LP Annville, LLC | Past | Accepting new patients | |
| East Bernstadt Medical Clinic PLLC | Family Medicine | Past |
Accepting new patients |
| East Bernstadt Medical Clinic PLLC | Family Medicine | Past |
Accepting new patients |
| Three Stores Inc | Past |
Accepting new patients | |
| Anand PSC | Past | Accepting new patients |
Locations
78 Highway 3444
Ste 1
Annville, KY 40402
Phone (606) 364-5162
11901 N Highway 421
Manchester, KY 40962
Phone (606) 598-2706
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 19661 | KY | |
| Family Medicine Physician | 207Q00000X | 19661 | KY | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000068622 | Other | KY | BCBS-BSMC |
| 000000062592 | Other | KY | BCBS-LCMC |
| 000000068623 | Other | KY | BCBS-EBMC |
| 000000245043 | Other | KY | BCBS-MMC |
| 000000047131 | Other | KY | BCBS-AMC |
| 64196611 | Medicaid | KY |
Other providers in London, KY
- Eleanor Holston Ham
- Cheyenne Mariah Hamblin
- Heather Marie Hammack
- Kyle Thomas Harris
- Joseph Hartfiel
- Jeremie Hays
- Healing Haven Inc
- Healing Waters Behavioral Health
- Health Express Urgent Care PLLC
- Heartstrings Mental Health PLLC
All providers in London, 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 Jun 1, 2016. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.