BLUEGRASS REGIONAL HEALTHCARE (NPI# 1609994789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609994789 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS REGIONAL HEALTHCARE |
| Practice Address |
1307 N Main St Beaver Dam KY 42320-8957 |
| Practice Telephone | 2702749222 |
| Practice Fax Number | 2702740696 |
| Mailing Telephone | 2702749222 |
| Mailing Fax Number | 2702740696 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SUSAN MATTHEWS (OWNER, PROVIDER) |
| Authorized Official Telephone | 2702749222 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2835P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 78006764 | 05 | |
| KY | LICENSE | 2835P | 01 |
| Street Address |
1307 N MAIN ST |
| City | BEAVER DAM |
| State | KY |
| Zip Code | 42320-8957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154745412 | Owensboro Health Medical Group, Inc | Surgery | 1307 N Main St, Beaver Dam, KY 42320-8957 | 2014-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386123198 | Tate Downing | Physical Therapist | 1595 Us Hwy 31 S, Beaver Dam, KY 42320 | 2018-08-13 |
| 1679792196 | Bradford Elrod Mutchler | Preventive Medicine | 1219 N. Main St, Beaver Dam, KY 42320 | 2007-04-24 |
| 1922169259 | Kenneth Dwain Alford | Dentist | 1269 Duvall Rd, Suite 2, Beaver Dam, KY 42320 | 2006-12-12 |
| 1205909330 | Susan Smith Rice | Nurse Practitioner | 1219 North Main St, Norsworthy Medical Assoc., Psc, Beaver Dam, KY 42320 | 2006-11-16 |
| 1104929322 | Armand Jules Rigaux | Emergency Medicine | 1219 N. Main St., Beaver Dam, KY 42320 | 2006-09-06 |
| 1326050329 | Jonathan L Shrewsbury | Optometrist | 1303 North Main St., Beaver Dam, KY 42320 | 2006-08-12 |
| 1376583690 | Donald Kevin Gregory | Emergency Medicine | 1213 North Main Street, Beaver Dam, KY 42320 | 2006-06-07 |
| 1982182317 | Bright Futures Behavioral Health | Nurse Practitioner | 1625 N Main St, Beaver Dam, KY 42320 | 2018-07-28 |
| 1669824744 | Aspire Behavioral Therapy, LLC | Counselor | 343 S Main St, Beaver Dam, KY 42320 | 2016-07-12 |
| 1457760662 | Wendy Russell | Counselor | 343 S Main St, Beaver Dam, KY 42320 | 2014-08-13 |
| Find all providers in zip 42320 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700872009 | Cynthia R Wilson | Nurse Practitioner | 1313 N Main St, Beaver Dam, KY 42320-8957 | 2005-09-22 |
| 1972598753 | Mary A Moore | Nurse Practitioner | 215 Corporate Dr, Suite B, Beaver Dam, WI 53916-3123 | 2005-09-16 |
| 1922000736 | Susan B Matthews | Nurse Practitioner | 1621 N Main St, Beaver Dam, KY 42320-8963 | 2005-08-11 |
| 1316941701 | Mary Ann Chambers | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2005-06-13 |
| 1871067553 | Chris Alan Thomas II | Nurse Practitioner | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-01-16 |
| 1215457288 | Courtney Nicole Keller | Nurse Practitioner | 1213 N Main St, Beaver Dam, KY 42320-8955 | 2017-06-21 |
| 1972973865 | Alelea B. Hewitt | Nurse Practitioner | 1520 N Main St, Beaver Dam, KY 42320-8960 | 2015-10-05 |
| 1134530769 | Lisa Drew | Nurse Practitioner | 110 Monroe St, Beaver Dam, WI 53916-2437 | 2014-05-16 |
| 1659700375 | Jennifer Shepard | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2013-11-04 |
| 1730513243 | Dawn Debra Poull | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2013-09-03 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 42320 |
Please comment or provide details below to improve the information on BLUEGRASS REGIONAL HEALTHCARE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.