Oak Tree Hospital at Baptist Northeast, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

OAK TREE HOSPITAL AT BAPTIST NORTHEAST, LLC

Practice address

1025 New Moody LN
La Grange, KY 40031-9154

Phone

(502) 222-8506

Fax

(502) 222-8526

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Joe Murrell

Title

Chief Executive Officer

Phone

(502) 222-8506

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 180150

Legal name

OAK TREE HOSPITAL AT BAPTIST HOSPITAL NORTHEAST

Certification status

Terminated Voluntary: merger or closure, Mar 31, 2007

Provider type (POS)

Hospital – Short-term

Participating since

Sep 29, 2006

Last certification

Sep 29, 2006

Beds

25

Ownership / control type

Church

Facility address

1025 New Moody Lane
La Grange, KY 40031

Hospital certification: CCN 182007

Legal name

OAK TREE HOSPITAL AT BAPTIST HOSPITAL NORTHEAST

Certification status

Terminated Voluntary: merger or closure, Sep 1, 2009

Provider type (POS)

Hospital – Long-term

Participating since

Apr 1, 2007

Last certification

Sep 29, 2006

Beds

33

Ownership / control type

Private (not for profit)

Facility address

1025 New Moody Lane, 1St Floor
La Grange, KY 40031

Member of 1

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

• Baptist Health Medical Group Inc

  dba Baptist Health Physical Therapy-Tates Creek

  • Durable Medical Equipment & Medical Supplies
  • Lexington, KY
  • NPI 1063650547

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1841240090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 NEW MOODY LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319154",
            "telephone_number": "502-222-8506",
            "fax_number": "502-222-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NEW MOODY LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319154",
            "telephone_number": "502-222-8506",
            "fax_number": "502-222-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE HOSPITAL AT BAPTIST NORTHEAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "MURRELL",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "502-222-8506"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01000462",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2861023000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50015894",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000496468",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Richard Noplis II, M.D.
• Northeast Joint Venture, LLC
• Chelsea Northrip
• Michael Raymond Norville, DO
• Selina Ann O'Coffey, LMFT
• Oaktree Hospital at Baptist Northeast, LLC
• Eziamara Oguibe-Shepherd, OTR/L
• Oldham County Ambulance Taxing District
• Oldham County Emergency Physicians, LLC
• Oldham County Health Dept

• Long Term Care Hospital in La Grange, KY
• Providers in La Grange, KY by specialty
• Long Term Care Hospital in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.