NPIMap

Organization Active NPI

Methodist Health, Inc.

Doing business as Methodist Family Medicine of Henderson North Elm

  • Family Medicine Physician
  • Henderson, KY
National Provider Identifier
1578997482
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
METHODIST HEALTH, INC.
Doing business as
Methodist Family Medicine of Henderson North Elm
Practice address
2000 N Elm St Ste 1a
Henderson, KY 42420-2385
Phone
(270) 631-2412
Fax
(270) 827-7475
NPI assigned
Aug 27, 2013
Last updated
Dec 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Authorized official

Name
Benny J Nolen
Title
Ceo
Phone
(270) 827-7501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2000 N Elm St Ste 1a
Henderson, KY 42420-2385

Mailing address

PO Box 638706
Cincinnati, OH 45263-8706
Phone (270) 827-7558

Other identifiers 1

IdentifierTypeStateIssuer
7100384560MedicaidKY

Other names 1

  • Methodist Family Medicine of Henderson North Elm Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000875 KY Part B Supplier - Clinic/Group Practice 4981508454 Receives reassigned benefits from 127 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Morganfield, KY; Henderson, KY; Dixon, KY

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1578997482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638706",
            "telephone_number": "270-827-7558",
            "fax_number": "270-827-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N ELM ST STE 1A",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202385",
            "telephone_number": "270-631-2412",
            "fax_number": "270-827-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "BENNY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-827-7501"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100384560",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Family Medicine of Henderson North Elm",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Methodist Family Medicine of Henderson North Elm",
            "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 Dec 6, 2018; 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.