NPIMap

Organization Active NPI

Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Scottsburg, IN
National Provider Identifier
1467057042
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BAPTIST HEALTH MEDICAL GROUP INC
Practice address
705 Fairground Rd
Scottsburg, IN 47170-6778
Phone
(812) 752-0165
Fax
(812) 752-0163
NPI assigned
Dec 2, 2020
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Matthew Lazari
Title
Vice President
Phone
(502) 489-8668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

705 Fairground Rd
Scottsburg, IN 47170-6778

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 253-4911

Other names 1

  • Scottsburg Primary Care Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090527000129 IN Part B Supplier - Clinic/Group Practice 5597867184 Receives reassigned benefits from 563 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Albany, IN; Palmyra, IN; Salem, IN; Scottsburg, IN; Sellersburg, IN; Charlestown, IN; Clarksville, IN; Corydon, IN…
O20210518000583 IN Part A Provider - Rural Health Clinic 5597867184 Practice locations: Scottsburg, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467057042. Details of each certification follow.

Rural health clinic certification: CCN 153917

Legal name
BAPTIST HEALTH MEDICAL GROUP INC
Doing business as
SCOTTSBURG PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 22, 2022
Last certification
Apr 22, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
705 Fairground Rd
Scottsburg, IN 47170-6778

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Baptist Medical Associates59 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Staci Dawn Farner Rogers Individual Corporate DirectorBoard Member Jan 1, 2022
Richard Carrico Individual Corporate OfficerVice President Apr 12, 2023
Christion Hutson Individual Corporate DirectorBoard Member Jan 1, 2026
Janet Norton Individual Corporate OfficerVice President Jul 21, 2006
Frank Purdy Individual Corporate DirectorBoard Member Jan 1, 2022
Victoria Buster Individual Corporate DirectorBoard Member Jan 1, 2023
Danyel D Clay Individual Corporate OfficerVice President Jan 1, 2023
W-2 Managing EmployeeVice President Jan 1, 2023
Isaac J Myers Individual Corporate OfficerPresident Jan 10, 2018
Susan S Tamme Individual Corporate DirectorBoard Member Jan 1, 2026
Joanne M Berryman Individual Corporate DirectorBoard Member Jan 1, 2024
Baptist Healthcare System Inc Organization, Louisville, KY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 19, 2017 100%
Ronald Douglas Reed Individual Corporate OfficerVice President Jan 17, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1467057042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-253-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 FAIRGROUND RD",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471706778",
            "telephone_number": "812-752-0165",
            "fax_number": "812-752-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "LAZARI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-489-8668"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scottsburg Primary Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Scottsburg Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsburg, IN

Sources for this page

Verify at the official NPI Registry.