Organization Active NPI

Owensboro Psychiatric Group PLLC

  • Psychiatry Physician
  • Owensboro, KY
National Provider Identifier
1891537510
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OWENSBORO PSYCHIATRIC GROUP PLLC
Practice address
5000 Back Square Dr Ste C200
Owensboro, KY 42301-7411
Phone
(270) 240-9200
Fax
(812) 492-6349
NPI assigned
Jun 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Dr. Rhine N Hejran, MDNPI 1740447754
Title
Member
Phone
(818) 451-5869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5000 Back Square Dr Ste C200
Owensboro, KY 42301-7411

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240828004567 KY Part B Supplier - Clinic/Group Practice 6204375736 Receives reassigned benefits from 1 practitioner
Practice locations: Owensboro, KY

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
18D2328656Owensboro Psychiatric Group5000 Back Square Dr Suite C200, Owensboro, KY 42301Certificate of waiverAug 13, 2027

National Provider Directory

National Provider Directory

Locations

5000 Back Square Dr
Ste C
Owensboro, KY 42301
Phone (270) 240-9200

5000 Back Square Dr
Ste C200
Owensboro, KY 42301
Phone (270) 240-9200

Practitioners & affiliated clinicians

Practitioners 1

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": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1891537510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-492-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BACK SQUARE DR STE C200",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017411",
            "telephone_number": "270-240-9200",
            "fax_number": "812-492-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO PSYCHIATRIC GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "HEJRAN",
        "authorized_official_first_name": "RHINE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "818-451-5869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.