NPIMap

Individual provider Active NPI

Peggy L. Harris, APRN

  • Family Nurse Practitioner
  • Madisonville, KY
National Provider Identifier
1992173330
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009842 Issued in KY
Practice address
444 S Main St
Madisonville, KY 42431-2846
Phone
(270) 821-4444
Fax
(270) 821-9188
NPI assigned
Sep 2, 2015
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1069555 KY
Family Nurse Practitioner 363LF0000X 3009842 KY Primary

Addresses

Primary practice location

444 S Main St
Madisonville, KY 42431-2846

Mailing address

PO Box 1595
Owensboro, KY 42302-1595
Phone (270) 691-8070

Other identifiers 1

IdentifierTypeStateIssuer
7100368720MedicaidKY

Other names 1

  • Peggy L. Moore Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pharris55254@direct.owensborohealth.org Owensboro Health Medical Group, Inc

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
I20151202002170 KY Practitioner - Nurse Practitioner 3779883483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

444 S Main St
Madisonville, KY 42431-2846
Phone (270) 821-4444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1069555KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Family CurrentSince Nov 2, 2015 Accepting new patients
Owensboro Health Medical Group, Inc Family CurrentSince Nov 2, 2015 Accepting new patients

Locations

444 S Main St
Madisonville, KY 42431
Phone (270) 821-4444

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Organizations & group practices 3

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 7

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": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1992173330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021595",
            "telephone_number": "270-691-8070",
            "fax_number": "270-691-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312846",
            "telephone_number": "270-821-4444",
            "fax_number": "270-821-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PEGGY",
        "middle_name": "L.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1069555",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100368720",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pharris55254@direct.owensborohealth.org",
            "affiliation": "Y",
            "affiliationName": "Owensboro Health Medical Group, Inc",
            "address_1": "444 S Main St",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "MOORE",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.