NPIMap

Organization Active NPI

St Elizabeth Medical Center, Inc

  • Clinical Medical Laboratory
  • Edgewood, KY
National Provider Identifier
1811154388
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ST ELIZABETH MEDICAL CENTER, INC
Practice address
1 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 301-2170
Fax
(859) 655-1773
NPI assigned
May 21, 2008
Last updated
Mar 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Lori Ritchey-Baldwin
Title
Cfo
Phone
(859) 655-1642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017

Mailing address

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 655-1889

Other identifiers 3

IdentifierTypeStateIssuer
000000061933OtherKYANTHEM REF LAB
0059383OtherAETNA
0474136OtherAETNA

Other names 1

  • St Elizabeth Edgewood Reference Laboratory Other name

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
18D0030958St Elizabeth Edgewood Lab1 Medical Village Drive, Edgewood, KY 41017AccreditationFeb 27, 2027
18D2148030Preferred Lab Partners,LLC1 Medical Village Drive, Suite B, Edgewood, KY 41017AccreditationApr 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeth Grant Coun26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1811154388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-655-1889",
            "fax_number": "859-655-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-2170",
            "fax_number": "859-655-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETH MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "RITCHEY-BALDWIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "859-655-1642"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM REF LAB",
            "identifier": "000000061933",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0059383",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0474136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth Edgewood Reference Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St Elizabeth Edgewood Reference Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.