NPIMap

Organization Active NPI

Owensboro Health Medical Group, Inc.

Doing business as Owensboro Health Henderson Healthplex

  • Family Medicine Physician
  • Henderson, KY
National Provider Identifier
1609394840
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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
Sep 8, 2017
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
OWENSBORO HEALTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Russell S Ranallo
Title
Secertary
Phone
(270) 417-4813

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X KY
Nurse Practitioner 363L00000X KY
Family Nurse Practitioner 363LF0000X KY
Primary Care Nurse Practitioner 363LP2300X KY
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X KY Primary
Sports Medicine (Family Medicine) Physician 207QS0010X KY
Internal Medicine Physician 207R00000X KY
Orthopaedic Surgery Physician 207X00000X KY
Pediatrics Physician 208000000X KY
Occupational Medicine Physician 2083X0100X KY
Diagnostic Radiology Physician 2085R0202X KY
Surgery Physician 208600000X KY
Pain Medicine Physician 208VP0000X KY
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

1200 Barrett Blvd
Henderson, KY 42420-4950

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070

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
O20040621000818 KY Part B Supplier - Clinic/Group Practice 0648255034 Receives reassigned benefits from 677 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Mohammed Kaleemuddin MD74 organizations share this tax ID, including this one
Part of
Omhs Behavioral Health

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

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1609394840",
    "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": "270-691-8070",
            "fax_number": "270-691-8026"
        },
        {
            "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": "2017-09-08",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "RANALLO",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECERTARY",
        "authorized_official_telephone_number": "270-417-4813"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Health Henderson Healthplex",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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 Nov 27, 2023; 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.