NPIMap

Organization Active NPI

Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1518360296
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
BAPTIST HEALTH MEDICAL GROUP INC
Practice address
4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone
(859) 260-4390
Fax
(859) 260-4399
NPI assigned
Oct 8, 2014
Last updated
Jun 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X KY
Primary Care Clinic/Center 261QP2300X 900311 KY
Rural Health Clinic/Center 261QR1300X KY
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU Primary
Professional Counselor 101YP2500X NU
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU
Pediatric Radiology Physician 2085P0229X NU
Podiatrist 213E00000X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20150206000249 KY Part B Supplier - Clinic/Group Practice 5597867184 Receives reassigned benefits from 1,113 practitioners
2 other NPIs on this enrollment
O20150603002897 KY Part A Provider - Rural Health Clinic 5597867184 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Barbourville, KY
O20150603003111 KY Part A Provider - Rural Health Clinic 5597867184 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamsburg, KY
O20170929003289 KY Part A Provider - Rural Health Clinic 5597867184 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Corbin, KY

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1518360296. Details of each certification follow.

Rural health clinic certification: CCN 188935

Legal name
BAPTIST HEALTH MEDICAL GROUP INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 2, 2014
Last certification
Mar 28, 2014
Ownership / control type
1B
Most recent change of ownership
Jan 1, 2015 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2015 in KY
Enrollment address
602 Knox St
Barbourville, KY 40906-1304

Rural health clinic certification: CCN 188940

Legal name
BAPTIST HEALTH MEDICAL GROUP INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 29, 2014
Last certification
Jul 29, 2014
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2015 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2015 in KY
Enrollment address
990 S Highway 25 W
Williamsburg, KY 40769-1692

Rural health clinic certification: CCN 188975

Legal name
BAPTIST HEALTH MEDICAL GROUP INC
Doing business as
BAPTIST HEALTH MEDICAL GROUP FAMILY MEDICINE CORBIN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 12, 2017
Last certification
Jun 12, 2017
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 2006 in KY
Enrollment address
96 Future Dr
Corbin, KY 40701-8988

Facilities connected through Provider of Services related, parent or unit certification numbers.

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

Member of 1

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

Locations

1700 Nicholasville Rd
Ste 1100
Lexington, KY 40503
Phone (859) 260-6856

1700 Nicholasville Rd
Ste 702
Lexington, KY 40503
Phone (859) 260-2585

1700 Nicholasville Rd
Ste 703
Lexington, KY 40503
Phone (859) 260-4390

100 Professional Dr
Ste 2
London, KY 40741
Phone (606) 330-4220

103 Alycia Dr
Ste 10
Richmond, KY 40475
Phone (859) 624-6515

793 Eastern Byp
Ste 106
Richmond, KY 40475
Phone (606) 624-1826

801 Eastern Byp
Ste 4
Richmond, KY 40475
Phone (606) 523-8779

115 Crossfield Dr
Versailles, KY 40383
Phone (502) 223-7403

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 OfficerSecretary Sep 1, 2014
Corporate OfficerSecretary Jan 1, 2015
Corporate OfficerVice President & Secretary 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
Corporate Director Jan 1, 2026
Joanne M Berryman Individual Corporate DirectorBoard Member Jan 1, 2024
Baptist Healthcare System Inc Organization, Louisville, KY Corporation, Non-profit Operational/Managerial Control Jan 1, 2015
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.

Practitioners & affiliated clinicians

Practitioners 1,121

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 1,121

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1518360296",
    "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",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR",
            "address_2": "STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40517",
            "telephone_number": "859-260-4390",
            "fax_number": "859-260-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "900311",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.