MEDICARE: METHODIST HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225016801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METHODIST HEALTH, INC.

Provider Business Mailing Address
First Line	:	PO BOX 638704
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-8704
Country	:	US
Telephone Number	:	270-827-7468
Fax Number	:	270-831-7804

Provider Business Practice Location Address
First Line	:	1305 NORTH ELM ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420
Country	:	US
Telephone Number	:	270-827-7700
Fax Number	:	270-827-7469

Authorized Official
Title or Position	:	VP
Name	:	STEPHANIE JENKINS
Credential	:
Telephone Number	:	270-827-7118

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	11/17/2020

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Directions to “METHODIST HEALTH, INC. ” Practice Location

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