Individual provider Active NPI

Andrew Peter Balbaugh, M.D.

  • Internal Medicine Physician
  • Georgetown, KY
National Provider Identifier
1265640411
Registry record updated Feb 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41057 Issued in KY
Practice address
196 Bevins LN
Suite F
Georgetown, KY 40324-8534
Phone
(502) 863-2818
Fax
(502) 863-2764
NPI assigned
May 20, 2007
Last updated
Feb 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 41057 KY
Internal Medicine Physician 207R00000X 41057 KY Primary

Addresses

Primary practice location

196 Bevins LN
Suite F
Georgetown, KY 40324-8534

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7906

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
I20071005000097 KY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4880789841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Northeastern Ohio University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Mso LLCGroup PAC ID 0749450633, 53 clinicians

Practice addresses (Care Compare)

1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9673
Phone (502) 570-2324

175 Hospital Dr
Suite 120
Georgetown, KY 40324
Phone (502) 570-2324

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41057KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC Internal Medicine Current Accepting new patients
Kentucky Mso LLC CurrentSince Jan 16, 2017 Accepting new patients
Kentucky Mso LLC CurrentSince Jan 16, 2017 Accepting new patients
Georgetown Community Hospital LLC Past Accepting new patients
Links Orthopedics, LLC Past Accepting new patients

Locations

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

196 Bevins Ln
Ste F
Georgetown, KY 40324
Phone (502) 863-2818

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: andrew.balbaugh.1@19475.direct.athenahealth.com

Organizations & group practices 6

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": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486771200000",
    "number": "1265640411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7906",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 BEVINS LN",
            "address_2": "SUITE F",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248534",
            "telephone_number": "502-863-2818",
            "fax_number": "502-863-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBAUGH",
        "first_name": "ANDREW",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-20",
        "last_updated": "2017-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "41057",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "41057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.