Organization Active NPI

Owensboro Health Medical Group Inc

Doing business as Owensboro Health Medical Group - Surgical Specialists

  • Surgery Physician
  • Greenville, KY
National Provider Identifier
1750760922
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
OWENSBORO HEALTH MEDICAL GROUP INC
Doing business as
Owensboro Health Medical Group - Surgical Specialists
Practice address
440 Hopkinsville St
Suite 2E
Greenville, KY 42345-1124
Phone
(270) 377-0111
Fax
(270) 377-0113
NPI assigned
May 21, 2015
Last updated
Dec 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OWENSBORO HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Mr. Russell S Ranallo
Title
Secretary
Phone
(270) 417-4813

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

440 Hopkinsville St
Suite 2E
Greenville, KY 42345-1124

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other names 1

  • Owensboro Health Medical Group - Surgical Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
Tax ID family
Cooperative Health Services74 organizations share this tax ID, including this one
Part of
Owensboro Medical Health

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

440 Hopkinsville St
Ste 2E
Greenville, KY 42345
Phone (270) 338-8000

910 Wallace Ave
Ste 302
Leitchfield, KY 42754
Phone (270) 259-2700

Practitioners & affiliated clinicians

Practitioners 6

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": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1750760922",
    "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": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 HOPKINSVILLE ST",
            "address_2": "SUITE 2E",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-377-0111",
            "fax_number": "270-377-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OWENSBORO HEALTH INC",
        "enumeration_date": "2015-05-21",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "RANALLO",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "270-417-4813",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Health Medical Group - Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.