Organization Active NPI

Murray-Calloway County Public Hospital Corporation

  • Family Medicine Physician
  • Benton, KY
National Provider Identifier
1689813594
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION
Doing business as
Albertson Family Medical
Practice address
543 Powell St
Benton, KY 42025
Phone
(270) 527-0045
Fax
(270) 527-0075
NPI assigned
Feb 17, 2009
Organization subpart
Yes
Parent organization
MURRAY CALLOWAY COUNTY PUBLIC HOSPTIALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Teresa Carpenter
Title
Executive Director
Phone
(702) 762-1281

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 02826 KY
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 02826 KY
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 1880P KY
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 3315P KY
Pediatric Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0200X 1880P KY

Addresses

Primary practice location

543 Powell St
Benton, KY 42025

Mailing address

300 S 8TH St
Suite 480 West
Murray, KY 42071-2400
Phone (270) 527-0045

Other identifiers 1

IdentifierTypeStateIssuer
7100094200MedicaidKY

Other names 1

  • Albertson Family Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429001328 KY Part B Supplier - Clinic/Group Practice 0840103297 Receives reassigned benefits from 105 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murray, KY

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Murraycalloway County Hospi

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1689813594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "address_2": "SUITE 480 WEST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-527-0045",
            "fax_number": "270-527-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 POWELL ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "42025",
            "telephone_number": "270-527-0045",
            "fax_number": "270-527-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MURRAY CALLOWAY COUNTY PUBLIC HOSPTIAL",
        "enumeration_date": "2009-02-17",
        "last_updated": "2021-09-10",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "702-762-1281"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "02826",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "02826",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "1880P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3315P",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "1880P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100094200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albertson Family Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Albertson Family Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.