NPIMap

Organization Active NPI

Hendersons Minor Outpatient Medicine, LLC

  • Family Medicine Physician
  • Henderson, KY
National Provider Identifier
1811947070
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HENDERSONS MINOR OUTPATIENT MEDICINE, LLC
Practice address
1015 N Elm St
Henderson, KY 42420-2712
Phone
(270) 826-8009
Fax
(270) 826-7010
NPI assigned
May 10, 2006
Last updated
Feb 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Dr. David Watkins, M.D.NPI 1174571095
Title
Partner
Phone
(270) 826-8009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1015 N Elm St
Henderson, KY 42420-2712

Mailing address

1015 N Elm St
Henderson, KY 42420-2712
Phone (270) 826-8009

Other identifiers 1

IdentifierTypeStateIssuer
65928160MedicaidKY

National Provider Directory

National Provider Directory

Locations

1015 N Elm St
Henderson, KY 42420
Phone (270) 826-8009

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1811947070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202712",
            "telephone_number": "270-826-8009",
            "fax_number": "270-826-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202712",
            "telephone_number": "270-826-8009",
            "fax_number": "270-826-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSONS MINOR OUTPATIENT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "270-826-8009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65928160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.