NPIMap

Organization Active NPI

Owensboro Health Medical Group, Inc.

Doing business as Owensboro Health Henderson Healthplex

  • Clinical Medical Laboratory
  • Henderson, KY
National Provider Identifier
1609374693
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
OWENSBORO HEALTH MEDICAL GROUP, INC.
Doing business as
Owensboro Health Henderson Healthplex
Practice address
1200 Barrett Blvd
Henderson, KY 42420-4950
Phone
(270) 844-8600
Fax
(270) 844-8610
NPI assigned
Jan 25, 2018
Last updated
Dec 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OWENSBORO HEALTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Mr. Russell S Ranallo
Title
Secretary
Phone
(270) 417-4813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X KY Primary

Addresses

Primary practice location

1200 Barrett Blvd
Henderson, KY 42420-4950

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other names 1

  • Owensboro Health Henderson Healthplex Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180413000630 KY Part B Supplier - Independent Clinical Laboratory 0648255034 Practice locations: Henderson, KY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Cooperative Health Services74 organizations share this tax ID, including this one
Part of
Owensboro Health Outpatient

Organizations with this tax ID in the same state 24

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

View all 24

Member of 1

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

Locations

25516 Network Pl
Chicago, IL 60673

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1609374693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BARRETT BLVD",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204950",
            "telephone_number": "270-844-8600",
            "fax_number": "270-844-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO HEALTH MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OWENSBORO HEALTH, INC",
        "enumeration_date": "2018-01-25",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "RANALLO",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "270-417-4813",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Health Henderson Healthplex",
            "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 28, 2022; 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.