NPIMap

Organization Active NPI

Pennyrile Area Development District

  • Supports Brokerage Agency
  • Hopkinsville, KY
National Provider Identifier
1437296167
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
Legal business name
PENNYRILE AREA DEVELOPMENT DISTRICT
Practice address
300 Hammond Dr
Hopkinsville, KY 42240-7952
Phone
(270) 886-9484
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dan Bozarth
Title
Executive Director
Phone
(270) 886-9484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X Primary

Addresses

Primary practice location

300 Hammond Dr
Hopkinsville, KY 42240-7952

Mailing address

300 Hammond Dr
Hopkinsville, KY 42240-7952
Phone (270) 886-9484

Other identifiers 1

IdentifierTypeStateIssuer
3300136300OtherKYSCL WAIVER

Other names 1

  • Pennyrile Area Agency on Aging Other name

National Provider Directory

National Provider Directory
Tax ID family
Pennyrile Area Development District4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Hammond Dr
Hopkinsville, KY 42240
Phone (270) 886-9484

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437296167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HAMMOND DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422407952",
            "telephone_number": "270-886-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HAMMOND DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422407952",
            "telephone_number": "270-886-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNYRILE AREA DEVELOPMENT DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOZARTH",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-886-9484"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCL WAIVER",
            "identifier": "3300136300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennyrile Area Agency on Aging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.