NPIMap

Organization Active NPI

Baptist Health Deaconess Madisonville Inc

Doing business as Baptist Health Deaconess Hospice

  • Community Based Hospice Care Agency
  • Madisonville, KY
National Provider Identifier
1891836235
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BAPTIST HEALTH DEACONESS MADISONVILLE INC
Doing business as
Baptist Health Deaconess Hospice
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 326-4660
Fax
(270) 326-4669
NPI assigned
Feb 9, 2007
Last updated
Aug 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Richard Carrico
Title
Chief Financial Officer
Phone
(502) 896-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 836-4660

Other identifiers 2

IdentifierTypeStateIssuer
000000054633OtherKYANTHEM PROVIDER NUMBER
44001758MedicaidKY

Other names 2

  • Baptist Health Deaconess Hospice Doing business as
  • Baptist Health Hospice Other name

Medicare participation

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

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2023 Change of OwnershipThis provider was the seller Hosparus Western KentuckyCCN 181527, KY, NPI 1093491904

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1891836235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-836-4660",
            "fax_number": "270-326-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-326-4660",
            "fax_number": "270-326-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH DEACONESS MADISONVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "CARRICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "502-896-5006"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000054633",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44001758",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Health Deaconess Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baptist Health Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.