Individual provider Active NPI

Ronnie Pridemore, M.D.

  • Emergency Medicine Physician
  • Elizabethtown, KY
National Provider Identifier
1285895334
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
48816 Issued in KY
Practice address
913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone
(877) 783-6257
Fax
(859) 514-5521
NPI assigned
Jun 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 48816 KY Primary

Addresses

Primary practice location

913 N Dixie Ave
Elizabethtown, KY 42701-2503

Mailing address

PO Box 910530
Lexington, KY 40591-0530
Phone (877) 783-6257

Other identifiers 1

IdentifierTypeStateIssuer
7100136250MedicaidKY

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
I20170224001515 KY Practitioner - Emergency Medicine 6305031832 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elizabethtown Emergency Physicians, LLCGroup PAC ID 9537067525, 22 clinicians

Practice addresses (Care Compare)

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 737-1212

Hospital & facility affiliations

  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012

Merit-based Incentive Payment System (MIPS)

Final score
92.76 of 100Reported as group
Quality
81.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48816KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T J Samson Community Hospital CurrentSince Mar 1, 2017 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
Elizabethtown Emergency Physicians, LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 8, 2017 Accepting new patients

Locations

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

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

Organizations & group practices 5

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 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": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1285895334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910530",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405910530",
            "telephone_number": "877-783-6257",
            "fax_number": "859-514-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012503",
            "telephone_number": "877-783-6257",
            "fax_number": "859-514-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "RONNIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-21",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "48816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100136250",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.