Owensboro Health Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Powderly, KY
NPI 1770001877 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1770001877
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- OWENSBORO HEALTH MEDICAL GROUP, INC.
- Practice address
- 2025 W Everly Brothers Blvd Ste 1a
Powderly, KY 42367-5401 - Phone
- (270) 377-2600
- Fax
- (270) 377-2610
- NPI assigned
- Sep 8, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- OWENSBORO HEALTH, INC
Authorized official
- Name
- Mr. Russell S Ranallo
- Title
- Secretary
- Phone
- (270) 417-4813
Practitioners 12
-
Tara Allen, APRN
-
Darci Blue Davis, RDN
-
Sabrina Kay Kirk, APRN
-
Nathan P. Lesueur, DPM
-
Shara Michelle McPherson, APRN
-
Ellen L. Parrish, DNP, APRN, FNP-BC
-
Gilbert Jean Louis, APRN-FNP
-
Sajeel Rehmat Khan, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Part of
- Owensboro Medical Health
Locations
2801 New Hartford Rd
Owensboro, KY 42303
Phone (270) 683-3720
2025 W Everly Brothers Blvd
Ste 1
Powderly, KY 42367
2025 W Everly Brothers Blvd
#1A
Powderly, KY 42367
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | |||
| Clinical Social Worker |
1041C0700X | |||
| Family Medicine Physician |
207Q00000X | KY | Yes | |
| Sports Medicine (Family Medicine) Physician |
207QS0010X | KY | ||
| Internal Medicine Physician |
207R00000X | KY | ||
| Cardiovascular Disease Physician |
207RC0000X | KY | ||
| Clinical Cardiac Electrophysiology Physician |
207RC0001X | KY | ||
| Interventional Cardiology Physician |
207RI0011X | KY | ||
| Orthopaedic Surgery Physician |
207X00000X | KY | ||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician |
2081P2900X | |||
| Diagnostic Radiology Physician |
2085R0202X | KY | ||
| Physician Assistant |
363A00000X | KY | ||
| Surgical Physician Assistant |
363AS0400X | KY | ||
| Family Nurse Practitioner |
363LF0000X | KY | ||
| Pediatric Nurse Practitioner |
363LP0200X |
Addresses
Primary practice location
2025 W Everly Brothers Blvd Ste 1a
Powderly, KY 42367-5401
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330
Other names
- Owensboro Health Muhlenberg Healthplex
Other providers in Powderly, KY
- Christopher Shawn Noffsinger
- Oh Muhlenberg, LLC
- Oh Muhlenberg, LLC
- Oh Muhlenberg, LLC
- Owensboro Health Medical Group, Inc
- Nancy M Powell
- Jane Hope Reed
- Sarah J. Renschler
- Laurie Roberts
- Brenda N Rogers
All providers in Powderly, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.