Healthcare Provider Details
I. General information
NPI: 1679407449
Provider Name (Legal Business Name): BAPTIST HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
313 FEDERAL DR NW STE 130
CORYDON IN
47112-3099
US
IV. Provider business mailing address
1901 CAMPUS PL
LOUISVILLE KY
40299-2308
US
V. Phone/Fax
- Phone: 812-738-4155
- Fax: 812-738-6104
- Phone: 502-253-4911
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANYEL
D
CLAY
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 502-253-4911