NPIMap

Organization Active NPI

Owensboro Health Medical Group Inc

Doing business as Owensboro Health Medical Group - Family Medicine

  • Family Medicine Physician
  • Owensboro, KY
National Provider Identifier
1457731515
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OWENSBORO HEALTH MEDICAL GROUP INC
Doing business as
Owensboro Health Medical Group - Family Medicine
Practice address
1325 Triplett St # a
Owensboro, KY 42303
Phone
(270) 686-8500
Fax
(270) 685-5467
NPI assigned
Jun 4, 2015
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OWENSBORO HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Russell S Ranallo
Title
Secretary
Phone
(270) 417-4813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Primary Care Nurse Practitioner 363LP2300X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1325 Triplett St # a
Owensboro, KY 42303

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 686-8500

Other names 1

  • Owensboro Health Medical Group - Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621000818 KY Part B Supplier - Clinic/Group Practice 0648255034 Receives reassigned benefits from 677 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Cooperative Health Services74 organizations share this tax ID, including this one
Part of
Omhs Behavioral Health

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 7

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": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1457731515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-686-8500",
            "fax_number": "270-685-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRIPLETT ST # A",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-686-8500",
            "fax_number": "270-685-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OWENSBORO HEALTH INC",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "RANALLO",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "270-417-4813"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Health Medical Group - Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.