Ephraim McDowell Health Resource, Inc.
Organization Active NPI Family Medicine Physician · Stanford, KY
NPI 1386799757 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1386799757
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 900145 (KY)
- Legal business name
- EPHRAIM MCDOWELL HEALTH RESOURCE, INC.
- Practice address
- 110 Metker TRL
Stanford, KY 40484-1065 - Phone
- (606) 365-3360
- NPI assigned
- Jan 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Amanda Kinman
- Title
- Cfo
- Phone
- (859) 239-2424
Other NPIs on the same Medicare enrollment 24
Member organizations 3
Change of ownership 1
Practitioners 33
-
Britni Barnett, APRN
-
Robert Bryan Bemiss, ARNP FNP-BC
-
Anne Marie Davis, ARNP
-
Deborah Edelen, ARNP
-
Melissa Dunaway Haddix, D.O.
-
Brittany M Hager, APRN FNP-BC
-
Sarah Haven Henzman, M.D.
-
Veronica House, FNP
-
Jesslyn Brianne Kelsey, APRN
-
Lindsay B Medley, APRN, DNP
-
Jonathan Morton, MD
-
Kellie Alicia Rosanbalm, APRN
-
Natalie Elizabeth Toffey, APRN
-
James A Turpin Jr., M.D.
-
Melissa Llenay Zook, M.D.
-
Leann S Brown, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jul 1, 2018 | Change of Ownership |
Fort Logan Walk-in & Primary Care |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031218000776 | KY | Part B Supplier - Clinic/Group Practice | 7517876956 |
Receives reassigned benefits from 259 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Stanford, KY; Springfield, KY; Somerset, KY; Liberty, KY; Lancaster, KY; Harrodsburg, KY; Danville, KY |
National Provider Directory
Locations
190 Daniel Dr
Danville, KY 40422
230 W Main St
Ste 102
Danville, KY 40422
Phone (859) 236-9620
440 Whirlaway Dr
Danville, KY 40422
Phone (859) 936-0303
250 Foxglove Dr
Mt Sterling, KY 40353
Phone (859) 498-3098
102 W Depot St
Springfield, KY 40069
Phone (606) 336-7343
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 900145 | KY | Yes |
Addresses
Primary practice location
110 Metker TRL
Stanford, KY 40484-1065
Mailing address
PO Box 990
Danville, KY 40423-0990
Phone (859) 239-2379
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35001478 | Medicaid | KY |
Other names
- Fort Logan Walk-in & Primary Care
Other providers in Stanford, KY
- Emhfl, Inc.
- Emhfl, Inc.
- Emhfl, Inc.
- Barbara L Emond
- Ephraim McDowell Health Resource, Inc
- Ephraim McDowell Regional Medical Center Incorporated
- Eye Health Specialists II, PLLC
- Faith Healthcare, Inc.
- Faith Healthcare, Inc.
- Miranda D Ferrie
All providers in Stanford, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2021. 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.