NPIMap

Individual provider Active NPI

Mary Joenborg

  • Family Medicine Physician
  • Mount Vernon, KY
National Provider Identifier
1437680964
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TP394 Issued in KY
Practice address
140 Newcomb Ave
Mount Vernon, KY 40456-2725
Phone
(606) 256-2195
NPI assigned
Mar 26, 2017
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP394 KY Primary

Addresses

Primary practice location

140 Newcomb Ave
Mount Vernon, KY 40456-2725

Mailing address

140 Newcomb Ave
Mount Vernon, KY 40456-2725
Phone (606) 256-2195

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
I20200806000752 KY Practitioner - Family Practice 9436409299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockcastle County Hospital, Inc.Group PAC ID 6103727433, 38 clinicians

Practice addresses (Care Compare)

140 Newcomb Ave
Mt Vernon, KY 40456-2728
Phone (606) 256-4148

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockcastle County Hospital, Inc. CurrentSince Jul 20, 2020 Accepting new patients
Rockcastle Ventures Inc. Doing Business As Rockcastle Clinic Family Medicine Current Accepting new patients
Rockcastle County Hospital, Inc. Family Medicine Current Accepting new patients
Rockcastle County Hospital, Inc. Family Medicine CurrentSince Jul 20, 2020 Accepting new patients
Rockcastle Ventures D.B.a. Rockcastle Family Health Family Medicine Past Accepting new patients

Locations

46 W Main St
Brodhead, KY 40409
Phone (606) 758-4748

140 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-3232

145 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-2195

Interoperability endpoints

  • Direct secure messaging: mary.joenborg@rpa.eclinicaldirectplus.com
  • Direct secure messaging: rhcmjoenbo@yourcarecommunity.org

Organizations & group practices 5

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": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1437680964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 NEWCOMB AVE",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404562725",
            "telephone_number": "606-256-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NEWCOMB AVE",
            "city": "MOUNT VERNON",
            "state": "KY",
            "postal_code": "404562725",
            "telephone_number": "606-256-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOENBORG",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, KY

Sources for this page

Verify at the official NPI Registry.