Bluegrass Med Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BLUEGRASS MED CARE

Practice address

4863 Scottsville Rd Ste B
Bowling Green, KY 42104-7949

Phone

(270) 843-5662

Fax

(270) 843-5614

NPI assigned

Oct 12, 2022

Last updated

Oct 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth LanhamNPI 1760713390

Title

Owner

Phone

(270) 843-5662

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 4

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.

• Elizabeth N. Lanham, PA-C

  • Physician Assistant
  • Bowling Green, KY
  • NPI 1760713390
  Medicare reassignment Care Compare group Authorized official
• Rebecca Fuqua, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
  • NPI 1932944121
  Medicare reassignment Care Compare group NPD
• Rosalie Padilla, M.D.

  • Internal Medicine Physician
  • Bowling Green, KY
  • NPI 1851354401
  Medicare reassignment Care Compare group NPD
• Malorie M. Mann, APRN, FNP-C

  • Family Nurse Practitioner
  • Bowling Green, KY
  • NPI 1417601444

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1861118895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4863 SCOTTSVILLE RD STE B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047949",
            "telephone_number": "270-843-5662",
            "fax_number": "270-843-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4863 SCOTTSVILLE RD STE B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047949",
            "telephone_number": "270-843-5662",
            "fax_number": "270-843-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS MED CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "LANHAM",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-843-5662"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100561960",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100796090",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64250715",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendal Lashea Bledsoe, MS
• Morgan Deann Blevins, LPCC
• Thomas J Blevins, DMD
• Blue Atlas LLC
• Bluegrass Counseling & Wellness
• Bluegrass Medical Care LLC
• Bluegrass Oral Health Center PLLC
• Bluegrass Outpatient Center of Bowling Green, L.L.C. (Bluegrass Outpatient Center)
• Bluegrass Surgical Association, PSC
• Daniel Agyei Boamah, LCSW

• Primary Care Clinic/Center in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.