Provider Demographics
NPI:1669791430
Name:OVERFELT, JAMES H (ARNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:OVERFELT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-218-9318
Practice Address - Street 1:510 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-218-9318
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006444363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6764OtherKY GROUP NUMBER
000000056294OtherANTHEM GROUP #
KY7100143000Medicaid
1487872636OtherARNP GROUP #
000000665303OtherANTHEM #
KYP00843209OtherMEDICARE RR #
KY7100143000Medicaid