Jon C Sivoravong, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04419 Issued in KY

Practice address

811 E Parrish Ave
Owensboro, KY 42303

Phone

(270) 691-8040

Fax

(270) 691-8049

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsivoravong91836@direct.owensborohealth.org

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.

• Owensboro Health Medical Group Inc

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  NPD
• Owensboro Health Medical Group Inc

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group Inc

  • Otolaryngology Physician
  • Horse Cave, KY
  • NPI 1891177556
  NPD

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1770545238",
    "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": "270-691-8070",
            "fax_number": "270-691-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-691-8040",
            "fax_number": "270-691-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 E Parrish Ave",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "42303",
            "country_code": "US",
            "telephone_number": "270-691-8040",
            "fax_number": "270-691-8049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVORAVONG",
        "first_name": "JON",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6729",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124874202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021015",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100572080",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080112014",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "847571",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsivoravong91836@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "811 E Parrish Ave",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "42303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsivoravong91836@direct.owensborohealth.org",
            "affiliation": "Y",
            "affiliationName": "Owensboro Health Medical Group, Inc.",
            "address_1": "811 E Parrish Ave Ste 102",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423033258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheldon Simon, D.P.M.
• Sean Robert Simone, D.C.
• Jamie Nicole Simpson, REGISTERED NURSE
• Gerald N. Sims Jr., MD
• Sabrina Sivaraman
• Ashly Nichole Skaggs, APRN
• Kathryn Skeens-Bailey
• Kathleen Marie Skeens, MD
• Jon A Skillman, O D
• David A Slosky, MD

• Family Medicine Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.