NPIMap

Organization Active NPI

Baptist Health Deaconess Madisonville Inc

Doing business as Baptist Health Deaconess Madisonville

  • Rehabilitation Hospital Unit
  • Madisonville, KY
National Provider Identifier
1811030257
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
BAPTIST HEALTH DEACONESS MADISONVILLE INC
Doing business as
Baptist Health Deaconess Madisonville
Practice address
900 Hospital Dr
Madisonville, KY 42431
Phone
(270) 825-5100
NPI assigned
Feb 15, 2007
Last updated
Aug 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Richard Carrico
Title
Cfo
Phone
(502) 896-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X KY Primary

Addresses

Primary practice location

900 Hospital Dr
Madisonville, KY 42431

Mailing address

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-5100

Other identifiers 1

IdentifierTypeStateIssuer
93000032MedicaidKY

Other names 1

  • BAPTIST HEALTH DEACONESS MADISONVILLE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070516000464 KY Part A Provider - Hospital 7113831199 Practice locations: Madisonville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811030257. Details of each certification follow.

Hospital certification: CCN 18T093

Legal name
BAPTIST HEALTH DEACONESS MADISONVILLE INC
Doing business as
BAPTIST HEALTH DEACONESS MADISONVILLE
Organization structure
CorporationNon-profit
Incorporated
Jul 20, 1938 in KY
Enrollment address
900 Hospital Dr
Madisonville, KY 42431-1644
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Baptist Health Deaconess MadisonvilleCCN 18T093 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Thomas P Sport MD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael a Davenport Individual Corporate DirectorDirector Jan 1, 2018
Baptist Health Deaconess, LLC Organization, Louisville, KY Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%
Eric Henderson Individual W-2 Managing EmployeeDirector of Reimbursement Oct 16, 2024
Ursula D Dugger Individual Corporate OfficerAssistant Secretary Jan 1, 2022
Danielle Metzger-Cundiff Individual W-2 Managing EmployeeSupervisor of Reimbursement Oct 16, 2024
Jason Hawkins Individual Corporate DirectorDirector Jan 1, 2023
Janet Norton Individual Corporate OfficerVP & Secretary Jan 1, 2022
Kent Waide Individual Corporate DirectorDirector Jan 1, 2023
Gerard Colman Individual Corporate DirectorDirector Sep 1, 2021
Alisa Coleman Individual Corporate OfficerPresident Jan 1, 2023
W-2 Managing EmployeeAd; Oct 16, 2024
Lynn C Lingafelter Individual Corporate DirectorDirector Sep 1, 2021
Roger Cox Individual Corporate DirectorFoundation Chair Jan 1, 2021
Robert Roosevelt Carter Individual Corporate DirectorDirector Jan 1, 2023
Valarie Howard Individual Corporate OfficerVice President Jul 1, 2025
W-2 Managing EmployeeVice President Oct 16, 2024
Shawn W McCoy Individual Corporate DirectorDirector Sep 1, 2021
Patrick Falvey Individual Corporate DirectorDirector Sep 1, 2021
Devalkumar Jitendrabhai Rajyaguru Individual Corporate DirectorDirector Jan 1, 2023
Lorie Oglesby Individual W-2 Managing EmployeeVP Human Resources & Education Nov 1, 2012

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baptist Health Deaconess Health at HomeMadisonville, KY, CCN 187013 Home health agency 5% Or Greater Direct Ownership Interest (50%) Oct 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1811030257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-825-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "42431",
            "telephone_number": "270-825-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH DEACONESS MADISONVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "CARRICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-896-5006"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93000032",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAPTIST HEALTH DEACONESS MADISONVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.