NPIMap

Individual provider Active NPI

Polly Lebuhn, M.D.

  • Internal Medicine Physician
  • Paducah, KY
National Provider Identifier
1417026949
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33449 Issued in KY
Practice address
225 Medical Center Drive
Suite 201
Paducah, KY 42003
Phone
(270) 441-4200
Fax
(270) 441-4249
NPI assigned
Nov 7, 2006
Last updated
May 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33449 KY Primary

Addresses

Primary practice location

225 Medical Center Drive
Suite 201
Paducah, KY 42003

Mailing address

2200 Jefferson Ave
5TH Floor Mercy Pho/Cvo
Toledo, OH 43604-7101
Phone (419) 251-9830

Other identifiers 1

IdentifierTypeStateIssuer
1184903MedicaidKY

Other names 1

  • Polly Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090416000713 KY Practitioner - Internal Medicine 6406903079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Kentucky LLCGroup PAC ID 1153488648, 20 clinicians

Practice addresses (Care Compare)

225 Medical Ctr Dr
Suite 205
Paducah, KY 42003-7907
Phone (270) 441-4462

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33449KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky LLC CurrentSince May 31, 2017 Accepting new patients
Mercy Health-Lourdes Hospital LLC Past Accepting new patients

Locations

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

225 Medical Center Dr
Ste 201
Paducah, KY 42003
Phone (270) 441-4200

225 Medical Center Dr
Ste 205
Paducah, KY 42003
Phone (270) 441-4462

225 Medical Center Dr
Ste 302
Paducah, KY 42003
Phone (270) 441-4300

Interoperability endpoints

  • Direct secure messaging: plebuhn188768@direct.bsmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1417026949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "5TH FLOOR MERCY PHO/CVO",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101",
            "telephone_number": "419-251-9830",
            "fax_number": "419-251-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 201",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42003",
            "telephone_number": "270-441-4200",
            "fax_number": "270-441-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBUHN",
        "first_name": "POLLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184903",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLLY",
            "last_name": "JOHNSON",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.