NPIMap

Organization Active NPI

Baptist Health Deaconess Medical Group Inc

  • Physical Therapy Clinic/Center
  • Powderly, KY
National Provider Identifier
1679154132
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BAPTIST HEALTH DEACONESS MEDICAL GROUP INC
Practice address
1010 Medical Center Dr
Powderly, KY 42367-5463
Phone
(270) 377-1621
NPI assigned
Apr 16, 2021
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Ms. Danyel Clay
Title
VP, Revenue Cycle & Coding
Phone
(502) 253-4911

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Physical Therapy Clinic/Center 261QP2000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

1010 Medical Center Dr
Powderly, KY 42367-5463

Mailing address

2701 Eastpoint Pkwy
Louisville, KY 40223-4166
Phone (502) 253-4911

Other names 1

  • Episodic Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210810000993 KY Part B Supplier - Clinic/Group Practice 6103220330 Receives reassigned benefits from 322 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Princeton, KY; Dawson Springs, KY; Powderly, KY; Madisonville, KY; Hopkinsville, KY; Clay, KY

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Baptist Health Deaconess Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

800 Hospital Dr
Fl 3
Madisonville, KY 42431
Phone (270) 326-4710

1010 Medical Center Dr
Ste G
Powderly, KY 42367

Practitioners & affiliated clinicians

Practitioners 12

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": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1679154132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 EASTPOINT PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234166",
            "telephone_number": "502-253-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "city": "POWDERLY",
            "state": "KY",
            "postal_code": "423675463",
            "telephone_number": "270-377-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH DEACONESS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "DANYEL",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE & CODING",
        "authorized_official_telephone_number": "502-253-4911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Episodic Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Powderly, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.