NPIMap

Organization Active NPI

Owensboro Family Medicine, PSC

  • Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1881879542
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
OWENSBORO FAMILY MEDICINE, PSC
Practice address
1325 Triplett St
Owensboro, KY 42303-3163
Phone
(270) 688-0829
NPI assigned
Dec 31, 2007
Organization subpart
Yes
Parent organization
OWENSBORO FAMILY MEDICINE,PSCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Ms. Sandy Goodman
Title
Office Manager
Phone
(270) 688-0829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1325 Triplett St
Owensboro, KY 42303-3163

Mailing address

PO Box 1370
Owensboro, KY 42302-1370

Other identifiers 1

IdentifierTypeStateIssuer
7100011750MedicaidKY

Other names 1

  • Owensboro Family Medicine, PSC Other name

National Provider Directory

National Provider Directory
Part of
Owensboro Family Medici

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1881879542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1370",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRIPLETT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033163",
            "telephone_number": "270-688-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO FAMILY MEDICINE, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OWENSBORO FAMILY MEDICINE,PSC",
        "enumeration_date": "2007-12-31",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-688-0829",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100011750",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Family Medicine, PSC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.