Provider Demographics
NPI:1114986197
Name:DAVID J. HAYS
Entity Type:Organization
Organization Name:DAVID J. HAYS
Other - Org Name:BURNING SPRINGS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INS. BILLING CREDENTIALING CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:606-843-6195
Mailing Address - Street 1:11901 N HIGHWAY 421
Mailing Address - Street 2:11901 NORTH HWY 421
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-4859
Mailing Address - Country:US
Mailing Address - Phone:606-598-2706
Mailing Address - Fax:606-598-0856
Practice Address - Street 1:11901 N HIGHWAY 421
Practice Address - Street 2:11901 NORTH HWY 421
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-4859
Practice Address - Country:US
Practice Address - Phone:606-598-2706
Practice Address - Fax:606-598-0856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100049180Medicaid
KY65907750Medicaid
KY7100045260Medicaid
KY65907750Medicaid