NPIMap

Organization Active NPI

Taylor Regional Medical Group

Doing business as Llewelyn Hortillosa M.D.

  • Psychiatry Physician
  • Campbellsville, KY
National Provider Identifier
1932157120
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
TAYLOR REGIONAL MEDICAL GROUP
Doing business as
Llewelyn Hortillosa M.D.
Practice address
1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone
(270) 465-3561
Fax
(270) 789-5805
NPI assigned
May 4, 2006
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
David Massengale
Title
Cfo
Phone
(270) 465-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X KY Primary

Addresses

Primary practice location

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615

Mailing address

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone (270) 465-3561

Other names 1

  • Llewelyn Hortillosa M.D. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051221000527 KY Part B Supplier - Clinic/Group Practice 4880616622 Receives reassigned benefits from 89 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, KY; Campbellsville, KY; Lebanon, KY; Greensburg, KY; Caompbellsville, KY

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Taylor Regional Pulmonology15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

1100 Lebanon Ave
Campbellsville, KY 42718
Phone (270) 465-5691

125 Kingswood Dr
Campbellsville, KY 42718
Phone (270) 465-0632

1698 Old Lebanon Rd
Ste A
Campbellsville, KY 42718

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1932157120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-465-3561",
            "fax_number": "270-789-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-465-3561",
            "fax_number": "270-789-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR REGIONAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "MASSENGALE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "270-465-3561"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Llewelyn Hortillosa M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.