Active NPI
Murray-Calloway County Public Hospital Corporation
- Family Medicine Physician
- Benton, KY
National Provider Identifier
1689813594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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 HOSPTIAL
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | 02826 | KY | |
| Pediatrics Physician | 208000000X | 02826 | KY | |
| Nurse Practitioner | 363L00000X | 1880P | KY | |
| Family Nurse Practitioner | 363LF0000X | 3315P | KY | |
| Pediatric Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100094200 | Medicaid | KY |
Other names 1
- Albertson Family Medical
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Rural Acute Care Hospital
- Murray, KY
- NPI 1063549814
O20040429001328
-
- Multi-Specialty Clinic/Center
- Murray, KY
- NPI 1093988388
O20040429001328
-
- Family Medicine Physician
- Benton, KY
- NPI 1255505087
O20040429001328
-
- Orthopaedic Surgery Physician
- Murray, KY
- NPI 1356580443
O20040429001328
-
- Adult Mental Health Clinic/Center
- Murray, KY
- NPI 1588894703
O20040429001328
-
- Multi-Specialty Clinic/Center
- Murray, KY
- NPI 1629202858
O20040429001328
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.