Individual provider Active NPI

Matthew Daniel Stone, M.D.

  • Internal Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1275829145
Registry record updated Jul 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56961 Issued in KY
Practice address
250 Park St
Bowling Green, KY 42101-1760
Phone
(270) 796-6540
Fax
(270) 796-6576
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TP893 KY
Internal Medicine Physician 207R00000X 51754 TN
Internal Medicine Physician 207R00000X 56961 KY Primary

Addresses

Primary practice location

250 Park St
Bowling Green, KY 42101-1760

Mailing address

PO Box 2697
Bowling Green, KY 42102-7697
Phone (270) 745-1100

Other practice location 1

1924 Alcoa Hwy # U-114
Knoxville, TN 37920-1511
Phone (895) 305-9340

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
I20220711000186 KY Practitioner - Internal Medicine 3971745407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2011
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) 745-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56961KYMDInternal Medicine Physician
51754TNMDInternal Medicine Physician
TP893KYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jun 6, 2022 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jun 6, 2022 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

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

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

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.

Hospital & facility affiliations 4

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1275829145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2697",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421027697",
            "telephone_number": "270-745-1100",
            "fax_number": "270-745-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-114",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "895-305-9340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "MATTHEW",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP893",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "51754",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "56961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.