Organization Active NPI

Pennyrile District Health Department

Doing business as Lyon County Health Department

  • Public Health or Welfare Agency
  • Eddyville, KY
National Provider Identifier
1386761435
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PENNYRILE DISTRICT HEALTH DEPARTMENT
Doing business as
Lyon County Health Department
Practice address
211 W Fairview Ave.
Eddyville, KY 42038
Phone
(270) 388-9763
Fax
(270) 388-5941
NPI assigned
Mar 23, 2007
Last updated
Jan 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
Allison L. Beshear
Title
Public Health Director
Phone
(270) 388-9747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X KY Primary

Addresses

Primary practice location

211 W Fairview Ave.
Eddyville, KY 42038

Mailing address

PO Box 96
Eddyville, KY 42038-0096
Phone (270) 388-9763

Other identifiers 2

IdentifierTypeStateIssuer
15001118MedicaidKY
20072013MedicaidKY

Other names 1

  • Lyon County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160226001351 KY Part B Supplier - Clinic/Group Practice 6002854650 Receives reassigned benefits from 1 practitioner
Practice locations: Eddyville, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

211 W Fairview Ave
Eddyville, KY 42038
Phone (270) 388-9763

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1386761435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "EDDYVILLE",
            "state": "KY",
            "postal_code": "420380096",
            "telephone_number": "270-388-9763",
            "fax_number": "270-388-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W FAIRVIEW AVE.",
            "city": "EDDYVILLE",
            "state": "KY",
            "postal_code": "42038",
            "telephone_number": "270-388-9763",
            "fax_number": "270-388-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNYRILE DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "BESHEAR",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "270-388-9747"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15001118",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20072013",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyon County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eddyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.