NPIMap

Organization Active NPI

Methodist Health, Inc.

Doing business as Methodist Family Medicine Letcher Street

  • Family Medicine Physician
  • Henderson, KY
National Provider Identifier
1346494671
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
METHODIST HEALTH, INC.
Doing business as
Methodist Family Medicine Letcher Street
Practice address
411 Letcher St
Henderson, KY 42420-4245
Phone
(270) 831-7950
Fax
(270) 831-7824
NPI assigned
Nov 13, 2008
Last updated
Aug 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Authorized official

Name
Mr. Benny J Nolen
Title
Ceo
Phone
(270) 827-7501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

411 Letcher St
Henderson, KY 42420-4245

Mailing address

PO Box 638706
Cincinnati, OH 45263-8706
Phone (270) 827-7558

Other identifiers 1

IdentifierTypeStateIssuer
7100392120MedicaidKY

Other names 1

  • Methodist Family Medicine Letcher Street Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000875 KY Part B Supplier - Clinic/Group Practice 4981508454 Receives reassigned benefits from 127 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Morganfield, KY; Henderson, KY; Dixon, KY

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1346494671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638706",
            "telephone_number": "270-827-7558",
            "fax_number": "270-827-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LETCHER ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204245",
            "telephone_number": "270-831-7950",
            "fax_number": "270-831-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "BENNY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-827-7501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100392120",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Family Medicine Letcher Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.