Baptist Health Medical Group Inc
Organization Active NPI Rural Health Clinic/Center · Scottsburg, IN
NPI 1467057042 · NPPES record last updated Jul 22, 2024
Key facts
- NPI
- 1467057042
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Danyel D Clay
- Title
- VP Revenue Cycle
- Phone
- (502) 253-4911
Owners & managing parties with NPI records 1
-
Staci Dawn Rogers, M.D.
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 6
Member of 1
Facilities with the same owner 29
Practitioners 22
-
Mary Cecelia Garner, PA-C
-
Kathleen Marion, PA
-
Christopher Miller, PA-C
-
Dana L Smallwood, FNP
-
Raven Thomas, PA
-
Erik W Achramowicz, D.O.
-
Amy J Hill, PAC
-
Remy Dulworth Lamphere, PA-C
-
Kenneth D Morrison, PA-C
-
Joel Lowell Parker, M.D.
-
Travis Parkulo, MD
-
Melissa Parshall, PA-C
-
Ty E Richardson, MD
-
Noah T Scherrer, M.D.
-
Ashlee Ann Vinyard, M.D.
-
Danny E. Winn, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
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
- Corporation · Non-profit
- Enrollment address
- 705 Fairground Rd
Scottsburg, IN 47170-6778
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Staci Dawn Farner Rogers |
Corporate Director |
Jan 1, 2022 | |
| Richard Carrico |
Corporate Officer |
Apr 12, 2023 | |
| Christion Hutson |
Corporate Director |
Jan 1, 2026 | |
| Janet Norton |
Corporate Officer |
Jul 21, 2006 | |
| Frank Purdy |
Corporate Director |
Jan 1, 2022 | |
| Victoria Buster |
Corporate Director |
Jan 1, 2023 | |
| Danyel D Clay |
Corporate Officer |
Jan 1, 2023 | |
| W-2 Managing Employee |
Jan 1, 2023 | ||
| Isaac J Myers |
Corporate Officer |
Jan 10, 2018 | |
| Susan S Tamme |
Corporate Director |
Jan 1, 2026 | |
| Joanne M Berryman |
Corporate Director |
Jan 1, 2024 | |
| Baptist Healthcare System Inc |
5% Or Greater Direct Ownership Interest | Apr 19, 2017 | 100% |
| Ronald Douglas Reed |
Corporate Officer |
Jan 17, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Baptist Health Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- Scottsburg Primary Care
Other providers in Scottsburg, IN
- Karen Amick
- Jason Anderson
- Assocaites in Pedicatric Therapy
- Shane A Avery
- Tonie Avery
- Baptist Health Medical Group Inc
- Molly Barnes
- Debra Jo Bartlett
- Toni Baumann
- Shera Kay Beckort
All providers in Scottsburg, IN · Rural Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.