Provider Demographics
NPI:1568452290
Name:BAPTIST HEALTHCARE SYSTEM, INC.
Entity Type:Organization
Organization Name:BAPTIST HEALTHCARE SYSTEM, INC.
Other - Org Name:BAPTIST HEALTH RICHMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-896-5006
Mailing Address - Street 1:1901 CAMPUS PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 EASTERN BYP
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-623-3131
Practice Address - Fax:859-625-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33601173000000X
207Q00000X, 363LF0000X
KY100322282N00000X
KY74900705367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054535OtherANTHEM BLUE CROSS
KY1083352OtherPASSPORT
KY5000007OtherUNITED HEALTHCARE
KY000000631053OtherBLUE CROSS - LEARN WELL CLINIC
KY030165200OtherBLACK LUNG PROVIDER #
KY0060054OtherAETNA PROVIDER #
KY01009141Medicaid
KY6593524900Medicaid
KY1083352OtherPASSPORT
KY0143Medicare ID - Type UnspecifiedPART B PROVIDER #