Individual provider Active NPI

Ann Marie Hemmer, MD

  • Pediatrics Physician
  • Munfordville, KY
National Provider Identifier
1336104405
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34970 Issued in KY
Practice address
117 West South Street
Munfordville, KY 42765
Phone
(270) 524-7231
Fax
(270) 524-7415
NPI assigned
Apr 20, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34970 KY Primary

Addresses

Primary practice location

117 West South Street
Munfordville, KY 42765

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
000000066277OtherKYANTHUM BCBS
1108056OtherPASSPORT MEDICAID MGDCARE
64394703MedicaidKY

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
I20200825001274 KY Practitioner - Pediatric Medicine 9436273687 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34970KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical C Enter of Hart County Pediatrics CurrentSince May 19, 2020 Accepting new patients
Family Medical Center of Hart Co Pediatrics CurrentSince May 19, 2020 Accepting new patients
T J Samson Community Hospital Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Medical Center of Hart CoMunfordville, KY, CCN 183897 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Director
Aug 27, 2010
Aug 27, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1336104405",
    "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": "42765",
            "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": "117 WEST SOUTH STREET",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "42765",
            "telephone_number": "270-524-7231",
            "fax_number": "270-524-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMMER",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "34970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHUM BCBS",
            "identifier": "000000066277",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT MEDICAID MGDCARE",
            "identifier": "1108056",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64394703",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munfordville, KY

Sources for this page

Verify at the official NPI Registry.