Richard W Medley Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13758 Issued in KY

Practice address

1220 Frederica St
Owensboro, KY 42301-3057

Phone

(270) 683-8858

NPI assigned

Aug 11, 2006

Reactivated

Jun 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225049232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 FREDERICA ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423013057",
            "telephone_number": "270-683-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 FREDERICA ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423013057",
            "telephone_number": "270-683-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-03-07",
        "deactivation_date": "2013-05-14",
        "reactivation_date": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "13758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000068534",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64137581",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Med 1St of Owensboro
• Med Source Plus, Inc
• Mediation & Counseling Center of Western Kentucky, Inc.
• Medical Electronics & Supplies Inc.
• Medical Specialists of Kentuckiana
• Sara Medsker
• Megan Meredith Counseling LLC
• Mariya Kumari Meheshwari
• Azizullah Mehrzad, MD
• Meijer Great Lakes Limited Partnership

• Internal Medicine Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.