NPIMap

Organization Active NPI

Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Georgetown, KY
National Provider Identifier
1972158475
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BAPTIST HEALTH MEDICAL GROUP INC
Practice address
210 Bevins LN
Georgetown, KY 40324-6120
Phone
(502) 868-0622
Fax
(502) 868-9097
NPI assigned
Aug 2, 2019
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST HEALTH MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Matthew Lazari
Title
Vice President
Phone
(502) 489-8668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

210 Bevins LN
Georgetown, KY 40324-6120

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 253-4911

Other names 1

  • Scott County Primary Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070228000503 KY Part B Supplier - Clinic/Group Practice 5597867184 Receives reassigned benefits from 1,548 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20191008002231 KY Part A Provider - Rural Health Clinic 5597867184 Practice locations: Georgetown, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972158475. Details of each certification follow.

Rural health clinic certification: CCN B03813

Legal name
BAPTIST HEALTH MEDICAL GROUP INC
Doing business as
SCOTT COUNTY PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 12, 2020
Last certification
Feb 12, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 2006 in KY
Enrollment address
210 Bevins LN
Ste C
Georgetown, KY 40324-6127

Other NPIs on the same Medicare enrollment 40

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

View all 40

National Provider Directory

National Provider Directory
Part of
Baptist Health Inc

Member of 1

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

Locations

210 Bevins Ln
Ste C
Georgetown, KY 40324
Phone (502) 868-0622

990 S Highway 25 W
Williamsburg, KY 40769
Phone (606) 549-8244

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Staci Dawn Farner Rogers Individual Corporate DirectorBoard Member Jan 1, 2022
Richard Carrico Individual Corporate OfficerVice President Apr 12, 2023
Christion Hutson Individual Corporate DirectorBoard Member Jan 1, 2026
Janet Norton Individual Corporate OfficerVice President & Secretary Jan 1, 2013
Frank Purdy Individual Corporate DirectorBoard Member Jan 1, 2022
Victoria Buster Individual Corporate DirectorBoard Member Jan 1, 2023
Danyel D Clay Individual Corporate OfficerVice President Jan 1, 2023
W-2 Managing EmployeeVice President Jan 1, 2023
Isaac J Myers Individual Corporate OfficerPresident Jan 10, 2018
Susan S Tamme Individual Corporate DirectorBoard Member Jan 1, 2026
Joanne M Berryman Individual Corporate DirectorBoard Member Jan 1, 2024
Baptist Healthcare System Inc Organization, Louisville, KY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Ronald Douglas Reed Individual Corporate OfficerVice President Jan 17, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1972158475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-253-4911",
            "fax_number": "502-489-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEVINS LN",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403246120",
            "telephone_number": "502-868-0622",
            "fax_number": "502-868-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST HEALTH MEDICAL GROUP INC",
        "enumeration_date": "2019-08-02",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "LAZARI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-489-8668"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott County Primary Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Scott County Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.