Individual provider Active NPI

Pavani Nathala

  • Family Medicine Physician
  • Elizabethtown, KY
National Provider Identifier
1699353086
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59684 Issued in KY
Practice address
100 Helmwood Plaza Dr
Elizabethtown, KY 42701-2975
Phone
(270) 769-5579
Fax
(270) 706-5547
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59684 KY Primary

Addresses

Primary practice location

100 Helmwood Plaza Dr
Elizabethtown, KY 42701-2975

Mailing address

100 Helmwood Plaza Dr
Elizabethtown, KY 42701-2975
Phone (502) 769-5579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703000836 KY Practitioner - Family Practice 5294117578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

100 Helmwood Plaza Dr
Elizabethtown, KY 42701-2975
Phone (270) 737-0077

Hospital & facility affiliations

  • Caresouth HHA Holdings of Winchester, LLC Dba Enhabit Home Health Home health agency, Owensboro, KY, CCN 187087
  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59684KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Apr 18, 2024 Accepting new patients
Baptist Health Medical Group Inc Family Medicine CurrentSince Apr 18, 2024 Accepting new patients

Locations

100 Helmwood Plaza Dr
Elizabethtown, KY 42701
Phone (270) 765-6242

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1699353086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HELMWOOD PLAZA DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012975",
            "telephone_number": "502-769-5579",
            "fax_number": "270-706-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HELMWOOD PLAZA DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012975",
            "telephone_number": "270-769-5579",
            "fax_number": "270-706-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHALA",
        "first_name": "PAVANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "59684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.