NPIMap

Organization Active NPI

Owensboro Internal Medicine Associates

  • Specialist
  • Owensboro, KY
National Provider Identifier
1255335774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
16324 Issued in KY
Legal business name
OWENSBORO INTERNAL MEDICINE ASSOCIATES
Doing business as
owensboro internal medicine associates
Practice address
815 E Parrish Ave
Ste 230
Owensboro, KY 42303-3222
Phone
(270) 688-2000
Fax
(270) 666-1204
NPI assigned
Jun 13, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bill Kelly
Title
Office Manager
Phone
(270) 688-1225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 16324 KY Primary

Addresses

Primary practice location

815 E Parrish Ave
Ste 230
Owensboro, KY 42303-3222

Mailing address

815 E Parrish Ave
Ste 230
Owensboro, KY 42303-3222
Phone (270) 688-2000

Other identifiers 4

IdentifierTypeStateIssuer
000000050189OtherKYBCBS ID NUMBER
0000000215988OtherKYBCBS ID NUMBER
000000050188OtherKYBCBS ID NUMBER
65922569MedicaidKY

Other names 1

  • owensboro internal medicine associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Owensboro Internal Medicine Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255335774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E PARRISH AVE",
            "address_2": "STE 230",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033222",
            "telephone_number": "270-688-2000",
            "fax_number": "270-666-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E PARRISH AVE",
            "address_2": "STE 230",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033222",
            "telephone_number": "270-688-2000",
            "fax_number": "270-666-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO INTERNAL MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-688-1225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "16324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "000000050189",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "0000000215988",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "000000050188",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65922569",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "owensboro internal medicine associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.