Active NPI
Owensboro Health Medical Group Inc
- Nurse Practitioner
- Dixon, KY
National Provider Identifier
1649652249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- OWENSBORO HEALTH MEDICAL GROUP INC
- Practice address
- 1871 US Highway 41a S
Dixon, KY 42409-9448 - Phone
- (270) 639-9440
- Fax
- (270) 639-9446
- NPI assigned
- Jun 19, 2015
- Organization subpart
- Yes
- Parent organization
- OWENSBORO HEALTH INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John T Hackbarth Jr.
- Title
- Secretary
- Phone
- (270) 417-4813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | KY | Primary |
Addresses
Primary practice location
1871 US Highway 41a S
Dixon, KY 42409-9448
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070
Other names 1
- Owensboro Health Medical Group - Family Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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- Part of
- Owensboro Medical Health
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Greenville, KY
- NPI 1699970533
-
- Internal Medicine Physician
- Linton, IN
- NPI 1861650442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1515024000000",
"number": "1649652249",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1871 US HIGHWAY 41A S",
"city": "DIXON",
"state": "KY",
"postal_code": "424099448",
"telephone_number": "270-639-9440",
"fax_number": "270-639-9446"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OWENSBORO HEALTH MEDICAL GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "OWENSBORO HEALTH INC",
"enumeration_date": "2015-06-19",
"last_updated": "2018-01-04",
"status": "A",
"authorized_official_last_name": "HACKBARTH",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "270-417-4813",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Owensboro Health Medical Group - Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dixon, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.