Baptist Health Medical Group Inc
Organization Active NPI Rural Health Clinic/Center · Lancaster, KY
NPI 1346946100 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1346946100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- BAPTIST HEALTH MEDICAL GROUP INC
- Practice address
- 187 Farra Dr
Lancaster, KY 40444-8764 - Phone
- (859) 792-1766
- Fax
- (859) 792-1793
- NPI assigned
- Feb 3, 2023
- Organization subpart
- No
Authorized official
- Name
- Danyel D Clay
- Title
- VP, Revenue Cycle
- Phone
- (502) 253-4911
Owners & managing parties with NPI records 1
-
Staci Dawn Rogers, M.D.
Other NPIs on the same Medicare enrollment 40
Practitioners 5
-
Madisan Miller, MD
-
Kellie Alicia Rosanbalm, APRN
-
David B Saxon, MD
-
James Robert Werkmeister, M.D.
-
Kelly J Werkmeister, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Rural health clinic certification: CCN B03947
- Legal name
- BAPTIST HEALTH MEDICAL GROUP INC
- Doing business as
- BAPTIST HEALTH MEDICAL GROUP PRIMARY CARE LANCASTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 31, 2024
- Last certification
- Jan 31, 2024
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 21, 2006 in KY
- Enrollment address
- 187 Farra Dr
Lancaster, KY 40444-8764
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Staci Dawn Farner Rogers |
Corporate Director |
Jan 1, 2022 | |
| Christion Hutson |
Corporate Director |
Jan 1, 2026 | |
| Janet Norton |
Corporate Officer |
Jul 21, 2006 | |
| Frank Purdy |
Corporate Director |
Jan 1, 2022 | |
| Victoria Buster |
Corporate Director |
Jan 1, 2023 | |
| Danyel D Clay |
Corporate Officer |
Jan 1, 2022 | |
| W-2 Managing Employee |
Jan 1, 2022 | ||
| Isaac J Myers |
Corporate Officer |
Jan 10, 2018 | |
| Rob D Schreiner |
Corporate Director |
Jan 1, 2021 | |
| Susan S Tamme |
Corporate Director |
Jan 1, 2026 | |
| Joanne M Berryman |
Corporate Director |
Jan 1, 2024 | |
| Ronald Douglas Reed |
Corporate Officer |
Jan 17, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070228000503 | KY | Part B Supplier - Clinic/Group Practice | 5597867184 |
Receives reassigned benefits from 1,548 practitioners 40 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20230531001258 | KY | Part a Provider - Rural Health Clinic | 5597867184 | Practice locations: Lancaster, KY |
National Provider Directory
Locations
2108 Nicholasville Rd
Fl 2
Lexington, KY 40503
Phone (859) 278-9413
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
187 Farra Dr
Lancaster, KY 40444-8764
Mailing address
1901 Campus PL FL 3
Louisville, KY 40299-2308
Phone (502) 253-4911
Other names
- Baptist Health Medical Group Primary Care Lancaster
Other providers in Lancaster, KY
- 4Seeds Medical Clinic, PLLC
- Adis Diagnostics LLC
- Misty Dawn Anderson
- Tariq A Arain
- Aspect Care Services LLC
- Behavioral Health Outpatient, LLC
- Renee Bell
- Devki Bhatt
- Bluegrass Family Medicine & Pediatrics PLLC
- Leona Brown
All providers in Lancaster, KY · Rural Health Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.