NPIMap

Organization Active NPI

Ack Healthcare Management, LLC

Doing business as Saint Camillus Urgent Care

  • Nurse Practitioner
  • Henderson, KY
National Provider Identifier
1508238452
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ACK HEALTHCARE MANAGEMENT, LLC
Doing business as
Saint Camillus Urgent Care
Practice address
1704 2ND St
Henderson, KY 42420
Phone
(270) 826-4433
NPI assigned
Oct 30, 2015
Last updated
Aug 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Authorized official

Name
Chuck Young
Title
Owner
Phone
(812) 489-0862

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

1704 2ND St
Henderson, KY 42420

Mailing address

PO Box 1099
Owensboro, KY 42302-1099
Phone (502) 277-5170

Other names 1

  • Saint Camillus Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140528001695 KY Part B Supplier - Clinic/Group Practice 3072736602 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hardinsburg, KY; Leitchfield, KY; Lewisport, KY

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1508238452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1099",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021099",
            "telephone_number": "502-277-5170",
            "fax_number": "502-277-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 2ND ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "42420",
            "telephone_number": "270-826-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACK HEALTHCARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-489-0862"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Camillus Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saint Camillus Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 29, 2019; 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.