Cory Michael Johanboeke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

913 N Dixie Ave
Elizabethtown, KY 42701-2503

Phone

(270) 737-1212

Fax

(270) 706-1141

NPI assigned

Aug 3, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

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)

Hospital & facility affiliations

• Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611

  KY

  Medicare reassignment Care Compare group
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Elizabethtown, KY
  • NPI 1093338527

  Physician Assistant

  NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD

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

• Baptist Healthcare System Inc

  • General Acute Care Hospital
  • Elizabethtown, KY
  • NPI 1689282147

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253404800000",
    "number": "1992936348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S HUBBARDS LN APT 237",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012503",
            "telephone_number": "270-737-1212",
            "fax_number": "270-706-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANBOEKE",
        "first_name": "CORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jewell, LPCC
• Jewish Hospital & St. Mary'S Healthcare, Inc.
• JG Connections Inc.
• Kimberly Merkley Jiranek, D.M.D
• Jkhall&Associates
• John J Duplessis, Jr.
• John Kenyon American Eye Institute LLC
• John Kenyon American Eye Institute, LLC
• Alexandria Johnson, CRNA
• Amanda Johnson, APRN

• Physician Assistant in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.