Individual provider Active NPI

Jennifer L Friend, MD

  • Emergency Medicine Physician
  • Campbellsville, KY
National Provider Identifier
1235145145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31708 Issued in KY
Practice address
1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone
(270) 384-9491
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31708 KY Primary

Addresses

Primary practice location

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (800) 893-9698

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
I20040329000326 KY Practitioner - Family Practice 6800788324 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31708KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Feb 17, 2014 Accepting new patients
Taylor County Hospital District Health Facilities Corporation Past Accepting new patients
Taylor County Hospital District Health Facilities Corporation Past Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161

1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235145145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-384-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEND",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "31708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.