Individual provider Active NPI

Samuel F. Hardcastle, M.D.

  • Internal Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1235133083
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34135 Issued in KY
Practice address
250 Park St
Suite 6B
Bowling Green, KY 42101-1760
Phone
(270) 745-1467
Fax
(270) 745-1156
NPI assigned
Jun 9, 2005
Last updated
Jan 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34135 KY Primary

Addresses

Primary practice location

250 Park St
Suite 6B
Bowling Green, KY 42101-1760

Mailing address

250 Park St
Suite 6B
Bowling Green, KY 42101-1760
Phone (270) 796-6540

Other identifiers 1

IdentifierTypeStateIssuer
64341357MedicaidKY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061102000467 KY Practitioner - Internal Medicine 9830196922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kentucky College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 781-7178

350 Park St
Bowling Green, KY 42101-1784

825 2ND Ave E
Suite C2
Bowling Green, KY 42101-1786

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc CurrentSince Oct 1, 2008 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Oct 1, 2008 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

250 Park St
Ste 204
Bowling Green, KY 42101
Phone (270) 796-6540

250 Park St
Ste 6B
Bowling Green, KY 42101

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

Organizations & group practices 4

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 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1235133083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "address_2": "SUITE 6B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "address_2": "SUITE 6B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-745-1467",
            "fax_number": "270-745-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDCASTLE",
        "first_name": "SAMUEL",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64341357",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.