NPIMap

Individual provider Active NPI

Brian T Odonoghue, MD

  • Family Medicine Physician
  • Hardinsburg, KY
National Provider Identifier
1962402842
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32124 Issued in KY
Practice address
107 Old Highway 60
Hardinsburg, KY 40143-2501
Phone
(270) 580-2250
NPI assigned
Jul 21, 2005
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32124 KY Primary

Addresses

Primary practice location

107 Old Highway 60
Hardinsburg, KY 40143-2501

Mailing address

107 Old Highway 60
Hardinsburg, KY 40143-2501
Phone (270) 580-2250

Other identifiers 3

IdentifierTypeStateIssuer
000000066552OtherKYANTHEM
1072079OtherKYPASSPORT
65900656MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000879 KY Practitioner - Family Practice 3870553134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breckinridge Health, Inc.Group PAC ID 0941106454, 14 clinicians

Practice addresses (Care Compare)

107 Old Hwy 60
Hardinsburg, KY 40143-2501
Phone (270) 756-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32124KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breckinridge Health, Inc Current Accepting new patients
Breckinridge Health Inc. CurrentSince Oct 9, 2017 Accepting new patients
Breckinridge Health Inc Family Medicine CurrentSince Oct 9, 2017 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Breckinridge Health, Inc. Past Accepting new patients
Breckinridge Health Inc Family Medicine Past Accepting new patients

Locations

209 Elm St
Cloverport, KY 40111
Phone (270) 788-3000

1011 Old Highway 60
Hardinsburg, KY 40143
Phone (270) 756-7000

107 Old Highway 60
Hardinsburg, KY 40143
Phone (270) 580-2250

Organizations & group practices 6

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 9

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1962402842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OLD HIGHWAY 60",
            "city": "HARDINSBURG",
            "state": "KY",
            "postal_code": "401432501",
            "telephone_number": "270-580-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 OLD HIGHWAY 60",
            "city": "HARDINSBURG",
            "state": "KY",
            "postal_code": "401432501",
            "telephone_number": "270-580-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONOGHUE",
        "first_name": "BRIAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "32124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000066552",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1072079",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65900656",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardinsburg, KY

Sources for this page

Verify at the official NPI Registry.