NPIMap

Organization Active NPI

Ephraim McDowell Health Resource, Inc

Doing business as Ephraim McDowell Stanford Medical Offices

  • Specialist
  • Stanford, KY
National Provider Identifier
1750790069
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Doing business as
Ephraim McDowell Stanford Medical Offices
Practice address
125 Portman Ave
Stanford, KY 40484-1229
Phone
(606) 365-3378
Fax
(606) 365-3381
NPI assigned
Aug 12, 2014
Last updated
Sep 10, 2021By the provider in NPPES
Organization subpart
No

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
Mr. Daniel McKay III
Title
Ceo
Phone
(859) 239-2409

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NU
Specialist 174400000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

125 Portman Ave
Stanford, KY 40484-1229

Mailing address

125 Portman Ave
Stanford, KY 40484-1229
Phone (606) 365-3378

Other names 1

  • Ephraim McDowell Stanford Medical Offices Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000776 KY Part B Supplier - Clinic/Group Practice 7517876956 Receives reassigned benefits from 259 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stanford, KY; Springfield, KY; Somerset, KY; Liberty, KY; Lancaster, KY; Harrodsburg, KY; Danville, KY

Other NPIs on the same Medicare enrollment 24

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

View all 24

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2242881Ephraim McDowell Stanford Medical Offices125 Portman Avenue, Stanford, KY 40484Certificate of waiverNov 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ephraim McDowell HLTH R17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

125 Portman Ave
Stanford, KY 40484
Phone (606) 365-3378

Practitioners & affiliated clinicians

Practitioners 5

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": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1750790069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PORTMAN AVE",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841229",
            "telephone_number": "606-365-3378",
            "fax_number": "606-365-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PORTMAN AVE",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841229",
            "telephone_number": "606-365-3378",
            "fax_number": "606-365-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHRAIM MCDOWELL HEALTH RESOURCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-239-2409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ephraim McDowell Stanford Medical Offices",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ephraim McDowell Stanford Medical Offices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanford, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.