Goutham Hebbalmath, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

46189 Issued in KY

Practice address

57 Summit Dr
Corbin, KY 40701-2746

Phone

(606) 528-9700

Fax

(606) 528-8423

NPI assigned

Sep 22, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ghebbalmath704196@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1568625648
  NPD (past)

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1629386701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBBALMATH",
        "first_name": "GOUTHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "46189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100256410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Nichole Haught-Lewis, BS
• Ray G Hays III, MD
• Healing Hands Health Center
• Health Management,LLC.
• Heart Specialists of SE Ky PSC
• Madison Nicole Hebert, ATC
• Rita A Hebert, MAT, ATC
• Chasity Heck
• Janice Hedayati, NP
• Jessica Brooke Hedrick, BA

• Pediatrics Physician in Corbin, KY
• Providers in Corbin, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.