OWENSBORO HEALTH WOUND CENTER-OHIO COUNTY
NPI 1154745412
Nurse Practitioner in Beaver Dam, KY

Active since February 06, 2014CLIA 18D2059164 · Waiver
1307 N MAIN ST, BEAVER DAM, KY 42320(270) 274-5602(270) 274-5612 Get Directions Write a Review

NPPES record last updated: December 1, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 1, 2022, May 4, 2022 (2 updates tracked since 2022).

About Owensboro Health Wound Center-ohio County NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OWENSBORO HEALTH WOUND CENTER-OHIO COUNTY (NPI 1154745412) is a healthcare organization registered as a nurse practitioner in Beaver Dam, Kentucky and active in the NPI registry since February 2014. The organization holds a CLIA Waiver certificate valid through May 19, 2027 and lists Russell S Ranallo, Secretary, as its authorized official.

NPPES Registry Identity

NPI1154745412
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameOWENSBORO HEALTH MEDICAL GROUP, INC
Location Address1307 N MAIN STBeaver Dam, KY 42320-8957
Mailing AddressPo Box 23229Owensboro, KY 42304-3229 · (270) 688-1330 · Fax (270) 688-1338
Fax(270) 274-5612
Organization SubpartYesParent: Owensboro Health, Inc
Authorized OfficialRussell S RanalloSecretary · (270) 417-4813
Enumeration DateFebruary 6, 2014
Last NPPES UpdateDecember 1, 20222 updates tracked since enumeration
NPPES CertifiedDecember 1, 2022
NPI 1154745412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedSurgeryTaxonomy 208600000X
1307 N MAIN ST, Beaver Dam, KY 42320

Other Names 1

Doing Business AsOwensboro Health Wound Center-ohio County

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2059164

Owensboro Health Wound Center Ohio County · Beaver Dam, KY
Active · expires May 19, 2027
CLIA Number18D2059164
Laboratory TypeCommunity Clinic
Certificate Effective DateMay 20, 2025
Certificate Expiration DateMay 19, 2027
Laboratory DirectorDr. Jeffrey Danetz
Laboratory Phone(270) 274-5601
Laboratory LocationOwensboro Health Wound Center Ohio County1307 North Main Street, Beaver Dam, KY 42320
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1307 N MAIN ST
BEAVER DAM, KY 42320
Nurse Practitioner (Family)
1307 N MAIN ST
BEAVER DAM, KY 42320

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Owensboro Health Medical Group, Inc's NPI number?

The NPI number for Owensboro Health Medical Group, Inc is 1154745412. It was assigned to this organization in the NPPES registry on February 6, 2014. The provider is doing business as Owensboro Health Wound Center-Ohio County.

Where is Owensboro Health Medical Group, Inc located?

Owensboro Health Medical Group, Inc is located at 1307 N Main St, Beaver Dam, KY 42320. The listed phone number is (270) 274-5602.

What is Owensboro Health Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Owensboro Health Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2059164) is associated with this NPI, valid through May 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Owensboro Health Medical Group, Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Owensboro Health Medical Group, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Owensboro Health Medical Group, Inc was last updated on December 1, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.