NPIMap

Organization Active NPI

Casey County Hospital District

Doing business as Casey County Hospital Medical Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Liberty, KY
National Provider Identifier
1649454067
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
31531 Issued in KY
Legal business name
CASEY COUNTY HOSPITAL DISTRICT
Doing business as
Casey County Hospital Medical Group
Practice address
187 Wolford Ave
Liberty, KY 42539-3278
Phone
(606) 787-6275
Fax
(606) 787-9717
NPI assigned
Dec 20, 2007
Last updated
Nov 3, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CASEY CO HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Mr. Rex A Tungate
Title
Ceo
Phone
(606) 787-6275

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 31531 KY Primary
Family Medicine Physician 207Q00000X NU
Diagnostic Radiology Physician 2085R0202X 28235 KY

Addresses

Primary practice location

187 Wolford Ave
Liberty, KY 42539-3278

Mailing address

187 Wolford Ave
Liberty, KY 42539-3278
Phone (606) 787-6275

Other identifiers 1

IdentifierTypeStateIssuer
65941304MedicaidKY

Other names 1

  • CASEY COUNTY HOSPITAL MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Casey County Primary Care Nursing Group8 organizations share this tax ID, including this one
Part of
Casey County Primary Care Nursing Group

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1649454067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393278",
            "telephone_number": "606-787-6275",
            "fax_number": "606-787-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393278",
            "telephone_number": "606-787-6275",
            "fax_number": "606-787-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASEY CO HOSPITAL DISTRICT",
        "enumeration_date": "2007-12-20",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "TUNGATE",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-787-6275",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "KY",
            "license": "31531",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "28235",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65941304",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASEY COUNTY HOSPITAL MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; 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.