NPIMap

Organization Active NPI

Caverna Memorial Hospital, Inc.

Doing business as CMH-Munfordville Physician Office

  • Rural Health Clinic/Center
  • Munfordville, KY
National Provider Identifier
1891803722
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900223 Issued in KY
Legal business name
CAVERNA MEMORIAL HOSPITAL, INC.
Doing business as
CMH-Munfordville Physician Office
Practice address
1134 Main St
Munfordville, KY 42765-9432
Phone
(270) 524-3641
Fax
(270) 524-7595
NPI assigned
Aug 29, 2006
Last updated
Sep 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Mr. Alan Alexander
Title
Ceo
Phone
(270) 786-2191

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 900223 KY Primary
Family Medicine Physician 207Q00000X 600065 KY
Internal Medicine Physician 207R00000X 600065 KY

Addresses

Primary practice location

1134 Main St
Munfordville, KY 42765-9432

Mailing address

PO Box 340
Munfordville, KY 42765-0340
Phone (270) 524-3641

Other identifiers 1

IdentifierTypeStateIssuer
7100092020MedicaidKY

Other names 1

  • CMH-Munfordville Physician Office Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Bowling Green Warren County Community Hospital Corporation42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

102 W Union St
Munfordville, KY 42765
Phone (270) 524-1201

1134 Main St
Munfordville, KY 42765
Phone (270) 524-3641

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2016 Change of OwnershipThis provider was the seller Med Center Health Primary Care MunfordvilleCCN 183465, KY, NPI 1801261029

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1891803722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "427650340",
            "telephone_number": "270-524-3641",
            "fax_number": "270-524-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 MAIN ST",
            "city": "MUNFORDVILLE",
            "state": "KY",
            "postal_code": "427659432",
            "telephone_number": "270-524-3641",
            "fax_number": "270-524-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVERNA MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-786-2191",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900223",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "600065",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "600065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100092020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMH-Munfordville Physician Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Munfordville, KY

Sources for this page

Verify at the official NPI Registry.