=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407576580
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JENNIE STUART MEDICAL CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2022
-----------------------------------------------------
Last Update Date | 11/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 N MAIN ST
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42286-9734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-466-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2400
-----------------------------------------------------
City | HOPKINSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42241-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PFS AND MANAGED CARE
-----------------------------------------------------
Name | AUTUMN BAILEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 270-887-0100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------