NPIMap

Organization Active NPI

Family Medical C Enter of Hart County

  • Physical Medicine & Rehabilitation Physician
  • Munfordville, KY
National Provider Identifier
1306020326
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
FAMILY MEDICAL C ENTER OF HART COUNTY
Practice address
205 Washington St
Munfordville, KY 42765-8900
Phone
(270) 524-7800
NPI assigned
Dec 27, 2007
Last updated
Jan 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY MEDICAL CENTER OF HART COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Authorized official

Name
Mr. James Wallace Middleton, M.D.NPI 1659337269
Title
Medical Director
Phone
(270) 524-7231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Pediatrics Physician 208000000X
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

205 Washington St
Munfordville, KY 42765-8900

Mailing address

PO Box 579
Munfordville, KY 42765-0579
Phone (270) 524-7231

Other identifiers 8

IdentifierTypeStateIssuer
7100120170OtherKYMEDICAID- PHYSICAL THERAPY GROUP
65904476MedicaidKY
7100197650OtherKYMEDICAID- PHYSICIAN OFFICE
K007193OtherCHAMPUS-TRICARE
CF7880OtherRAILROAD MEDICARE
000000057825OtherKYANTHEM
1064127OtherKYPASSPORT-SPECIALTIST GROUP
1064168OtherPASSPORT

Other names 1

  • Family Medical Center of Hart County Non-RHC Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@MunfordvilleFMC.e-mdsdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000364 KY Part B Supplier - Clinic/Group Practice 3274428701 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Munfordville, KY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Center of Hart Co2 organizations share this tax ID, including this one
Part of
Family Medical Center of Hart Co

Other organizations with this tax ID 1

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

Locations

205 Washington St
Munfordville, KY 42765
Phone (270) 524-7800

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1306020326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "427650579",
            "telephone_number": "270-524-7231",
            "fax_number": "270-524-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WASHINGTON ST",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "427658900",
            "telephone_number": "270-524-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL C ENTER OF HART COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY MEDICAL CENTER OF HART COUNTY",
        "enumeration_date": "2007-12-27",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "270-524-7231",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- PHYSICAL THERAPY GROUP",
            "identifier": "7100120170",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65904476",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- PHYSICIAN OFFICE",
            "identifier": "7100197650",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-TRICARE",
            "identifier": "K007193",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF7880",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000057825",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT-SPECIALTIST GROUP",
            "identifier": "1064127",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1064168",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@MunfordvilleFMC.e-mdsdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "117 W South St",
            "city": "Munfordville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "42765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Family Medical Center of Hart County Non-RHC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Family Medical Center of Hart County Non-RHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Munfordville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.