Provider Demographics
NPI: | 1669452967 |
---|---|
Name: | BAPTIST HEALTH MADISONVILLE INC |
Entity Type: | Organization |
Organization Name: | BAPTIST HEALTH MADISONVILLE INC |
Other - Org Name: | BAPTIST HEALTH MADISONVILLE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | MR |
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: | 900 HOSPITAL DR |
Mailing Address - Street 2: | |
Mailing Address - City: | MADISONVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 42431-1644 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 270-825-5100 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 900 HOSPITAL DR |
Practice Address - Street 2: | |
Practice Address - City: | MADISONVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 42431-1644 |
Practice Address - Country: | US |
Practice Address - Phone: | 270-825-5100 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-01-20 |
Last Update Date: | 2023-08-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
No | 237700000X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KY | 65927196 | Medicaid | |
KY | 89900211 | Medicaid | |
KY | 70900121 | Medicaid | |
KY | 77902666 | Medicaid | |
KY | 95901054 | Medicaid | |
KY | 50900257 | Medicaid | |
KY | 78900370 | Medicaid | |
KY | 80900079 | Medicaid | |
KY | 74903998 | Medicaid | |
KY | 82900127 | Medicaid | |
KY | 65927196 | Medicaid |