NPIMap

Organization Active NPI

Western Baptist Medical Ventures, Inc.

Doing business as Paducah Neurosurgical Center

  • Neurological Surgery Physician
  • Paducah, KY
National Provider Identifier
1316017080
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
WESTERN BAPTIST MEDICAL VENTURES, INC.
Doing business as
Paducah Neurosurgical Center
Practice address
2603 Kentucky Ave Ste 404
Paducah, KY 42003-3830
Phone
(270) 443-6472
Fax
(270) 442-1649
NPI assigned
Nov 9, 2006
Last updated
Jan 19, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
WESTERN BAPTIST MEDICAL VENTURES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Larry Barton
Title
Vice President
Phone
(270) 575-2139

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Family Nurse Practitioner 363LF0000X 4059P KY
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

2603 Kentucky Ave Ste 404
Paducah, KY 42003-3830

Mailing address

PO Box 7909
Paducah, KY 42002-7909
Phone (270) 575-2139

Other identifiers 4

IdentifierTypeStateIssuer
DF7549OtherKYRAILROAD MEDICARE
7100002230MedicaidKY
65945867MedicaidKY
000000521597OtherKYANTHEM BCBS

Other names 1

  • Paducah Neurosurgical Center Doing business as

National Provider Directory

National Provider Directory
Part of
Western Baptist Medical Venturesinc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1316017080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7909",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420027909",
            "telephone_number": "270-575-2139",
            "fax_number": "270-575-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 KENTUCKY AVE STE 404",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033830",
            "telephone_number": "270-443-6472",
            "fax_number": "270-442-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN BAPTIST MEDICAL VENTURES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN BAPTIST MEDICAL VENTURES, INC.",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "270-575-2139"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4059P",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF7549",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100002230",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945867",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000521597",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paducah Neurosurgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.