NPIMap

Organization Active NPI

Matthew 25 AIDS Services Inc

  • Clinic/Center
  • Henderson, KY
National Provider Identifier
1457355125
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
740146 Issued in KY
Legal business name
MATTHEW 25 AIDS SERVICES INC
Practice address
452 Old Corydon Rd
Henderson, KY 42420-4645
Phone
(270) 826-0200
Fax
(270) 826-0212
NPI assigned
Jun 9, 2005
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Courtney Woolfork
Title
Ceo
Phone
(270) 826-0200

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Family Medicine Physician 207Q00000X
Clinic/Center 261Q00000X 740146 KY Primary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

452 Old Corydon Rd
Henderson, KY 42420-4645

Mailing address

452 Old Corydon Rd
Henderson, KY 42420-4645
Phone (270) 826-0200

Other identifiers 5

IdentifierTypeStateIssuer
78902822MedicaidKY
23130245OtherKYPASSPORT HEALTH PLAN
92-00380OtherUNITED HEALTHCARE
000000246990OtherKYANTHEM KY & IN
200408870MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040727000113 KY Part B Supplier - Clinic/Group Practice 3375513641 Receives reassigned benefits from 7 practitioners
Practice locations: Bowling Green, KY; Henderson, KY; Owensboro, KY
O20080624000755 IN Part B Supplier - Clinic/Group Practice 3375513641 Receives reassigned benefits from 4 practitioners
Practice locations: Evansville, IN

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0992801Matthew 25 AIDS Services Inc452 Old Cordyon Rd, Henderson, KY 42420Provider-performed microscopyOct 24, 2027

National Provider Directory

National Provider Directory

Locations

101 NW 1st St
Ste 215
Evansville, IN 47708
Phone (812) 437-5192

612 SE 4th St
Evansville, IN 47713
Phone (812) 435-2450

944 Fields Dr
Ste 102
Bowling Green, KY 42104
Phone (270) 495-1312

452 Old Corydon Rd
Henderson, KY 42420
Phone (270) 826-0200

1901 Leitchfield Rd
#A
Owensboro, KY 42303
Phone (270) 826-0200

Practitioners & affiliated clinicians

Practitioners 9

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": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1457355125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 OLD CORYDON RD",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204645",
            "telephone_number": "270-826-0200",
            "fax_number": "270-826-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 OLD CORYDON RD",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204645",
            "telephone_number": "270-826-0200",
            "fax_number": "270-826-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW 25 AIDS SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "WOOLFORK",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-826-0200"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KY",
            "license": "740146",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78902822",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "23130245",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "92-00380",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM KY & IN",
            "identifier": "000000246990",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200408870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.