Individual provider Active NPI

Russell W Carter, D.O.

  • Gastroenterology Physician
  • Paducah, KY
National Provider Identifier
1912976085
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
02476 Issued in KY
Practice address
2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3800
Phone
(270) 415-4690
Fax
(270) 415-4691
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036102415 IL
Gastroenterology Physician 207RG0100X 02476 KY Primary

Addresses

Primary practice location

2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3800

Mailing address

2605 Kentucky Ave
Suite 306
Paducah, KY 42003-3800
Phone (270) 415-4690

Other identifiers 1

IdentifierTypeStateIssuer
64024763MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcarter6263@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000256 KY Practitioner - Gastroenterology 6002957883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ohio University, College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2605 Kentucky Ave
Suite 202
Paducah, KY 42003-3801
Phone (270) 441-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy180
Upper gastrointestinal (GI) endoscopy for acid reflux131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036102415ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Sep 28, 2015 Accepting new patients
Baptist Health Medical Group Inc Gastroenterology Past Accepting new patients

Locations

800 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3800

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

225 Medical Center Dr
Ste 307
Paducah, KY 42003
Phone (270) 441-4700

2605 Kentucky Ave
Ste 306
Paducah, KY 42003
Phone (270) 415-7653

2605 Kentucky Ave
Ste 202
Paducah, KY 42003
Phone (270) 415-4690

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1912976085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-4690",
            "fax_number": "270-415-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 202",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-4690",
            "fax_number": "270-415-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "RUSSELL",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036102415",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "02476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64024763",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarter6263@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2605 Kentucky Ave",
            "address_2": "Suite 202",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.