Covered Entity Details

DSH180103H Baptist Health Lexington (Active) - information as of 6/22/2025 11:09:36 PM

Main Details

Name

Baptist Health Lexington

Subdivision Name

Baptist Health Lexington Anticoagulation Clinic - Medication Therapy Management

Type

Disproportionate Share Hospital

Rural

340B ID

DSH180103H

Medicare Provider Number

180103

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/10/2019

Participating Start Date

1/1/2020

Participating Approval Date

11/24/2019

Last Recertification Date

8/15/2024

Contacts

Authorizing Official

Baptist Health Lexington
Christopher M. Roty, President
(859) 260-6104

Primary Contact

Baptist Health Lexington
Brian Host, Director of Pharmacy
(859) 260-5177

Addresses

Street Address

1720 Nicholasville Road Suite 606
Lexington, KY 40503

Billing Address

Baptist Health Lexington
1740 Nicholasville Road
Lexington, KY 40503

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
KY		1538244918
IL		1538244918
TN		1538244918
IN		1538244918
OH		1538244918

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH180103A	Child	DSH	Baptist Health Lexington	BAPTIST HEALTH MEDICAL PLAZA RICHMOND	107 MERIDIAN WAY	RICHMOND	KY	Terminated
DSH180103B	Child	DSH	Baptist Health Lexington	Baptist Health Medical Plaza at Brannon Crossing - Building 2	610 E. Brannon Rd.	Nicholasville	KY	Active
DSH180103C	Child	DSH	Baptist Health Lexington	Baptist Health Infusion Frankfort	107 Diagnostic Drive	Frankfort	KY	Active
DSH180103D	Child	DSH	Baptist Health Lexington	Baptist Health Lexington Outpatient Oncology	1700 Nicholasville Rd	Lexington	KY	Active
DSH180103E	Child	DSH	Baptist Health Lexington	Baptist Health Lexington Cardiology - Electrocardiology	1720 Nicholasville Road	Lexington	KY	Active
DSH180103F	Child	DSH	Baptist Health Lexington	Baptist Health Lexington Cardiovascular Observation Unit - ELECTROCARDIOLOGY	1720 Nicholasville Road	Lexington	KY	Active
DSH180103G	Child	DSH	Baptist Health Lexington	Baptist Health Lexington Cardiac Cath Lab - CARDIAC CATHETERIZATION	1720 Nicholasville Road	Lexington	KY	Active
DSH180103H	Child	DSH	Baptist Health Lexington	Baptist Health Lexington Anticoagulation Clinic - Medication Therapy Management	1720 Nicholasville Road Suite 606	Lexington	KY	Active
DSH180103J	Child	DSH	Baptist Health Lexington	Radiology diagnostics - Radiology Diagnostic Alysheba	1775 Alysheba Way	Lexington	KY	Active
DSH180103K	Child	DSH	Baptist Health Lexington	Electrocardiology - NONINVASIVE LAB	3000 Baptist Health Blvd	Lexington	KY	Active
DSH180103L	Child	DSH	Baptist Health Lexington	OP ONCOLOGY - OUTPATIENT ONCOLOGY	3000 Baptist Health Blvd	Lexington	KY	Active
DSH180103M	Child	DSH	Baptist Health Lexington	Emergency - EMERGENCY DEPT	3000 Baptist Health Blvd	Lexington	KY	Active
DSH180103N	Child	DSH	Baptist Health Lexington	ELECTROCARDIOLOGY - CARDIOLOGY	3000 Baptist Health Blvd	Lexington	KY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/14/2023 12:48:37 PM	8/15/2024 9:18:54 AM	8/15/2024 9:18 AM
Contacts	Primary Contact	Update	Change Request	Anderson, Michael Director of Pharmacy Baptist Health Lexington 8592606498	Host, Brian Director of Pharmacy Baptist Health Lexington 8592605177	7/11/2024 8:13 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	610444707006 (IL)		10/6/2023 3:58 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	01012566 (KY)		10/6/2023 3:58 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	Q035778 (TN)		10/6/2023 3:58 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	300036092 (IN)		10/6/2023 3:58 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1406535 (OH)		10/6/2023 3:58 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1144688318 (IN)		10/6/2023 3:58 PM
Details	Last Recertification Date	Update	Recertification	8/31/2022 9:51:03 AM	8/14/2023 12:48:37 PM	8/14/2023 12:48 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	902582100 (FL)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	003221806A (GA)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1538244918 (MI)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1538244918 (NC)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	10026751300 (NE)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1538244918 (VA)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1538244918 (WV)		4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/11/2023 3:33 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1406535	4/11/2023 3:33 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		OH	4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (GA)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (NE)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (NC)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (MI)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (WV)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (VA)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1538244918 (FL)		4/11/2023 3:33 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1538244918	4/11/2023 3:33 PM
Medicaid Billing	NPI: State	Insert	Change Request		OH	4/11/2023 3:33 PM
Details	Last Recertification Date	Update	Recertification	8/16/2021 2:57:36 PM	8/31/2022 9:51:03 AM	8/31/2022 9:51 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	6/15/2022 2:09 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		300036092	6/15/2022 2:09 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		IN	6/15/2022 2:09 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1144688318	6/15/2022 2:09 PM
Medicaid Billing	NPI: State	Insert	Change Request		IN	6/15/2022 2:09 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1538244918	6/15/2022 2:09 PM
Medicaid Billing	NPI: State	Insert	Change Request		IN	6/15/2022 2:09 PM
Contacts	Authorizing Official	Update	Change Request	Sisson, Bill President Baptist Health Lexington 8592606104	Roty, Christopher M. President Baptist Health Lexington 8592606104	2/28/2022 4:01 PM
Details	Last Recertification Date	Update	Recertification	8/19/2020 10:29:35 AM	8/16/2021 2:57:36 PM	8/16/2021 2:57 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1538244918 ( )		8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		GA	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		NE	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		NC	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		MI	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		WV	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		VA	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		IL	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		FL	8/19/2020 10:29 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1538244918	8/19/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		TN	8/19/2020 10:29 AM
Details	Last Recertification Date	Update	Recertification		8/19/2020 10:29:35 AM	8/19/2020 10:29 AM
Details	State	Update		Approved	Active	1/1/2020 12:04 AM
Contacts	Signed By	Insert	New Registration		Sisson, Bill President Baptist Health Lexington 8592606104	11/24/2019 5:34 PM
Details	340B ID	Update	New Registration		DSH180103H	11/24/2019 5:34 PM
Details	Entity Name	Update	New Registration	BAPTIST HEALTH LEXINGTON	Baptist Health Lexington	11/24/2019 5:34 PM
Details	Entity Subname	Update	New Registration	Baptist Health Lexington Anticoagulation Clinic	Baptist Health Lexington Anticoagulation Clinic - Medication Therapy Management	11/24/2019 5:34 PM
Dates	Participating Approval Date	Update	New Registration		11/24/2019 5:34:53 PM	11/24/2019 5:34 PM
Details	State	Update	New Registration	Pending	Approved	11/24/2019 5:34 PM
Dates	Signed By Date	Update	New Registration		10/10/2019 11:33:37 AM	11/24/2019 5:34 PM
Dates	Start Date	Update	New Registration		1/1/2020 12:00:00 AM	11/24/2019 5:34 PM
Addresses	Main Address	Insert	New Registration		1720 Nicholasville Road Suite 606 Lexington, KY 40503	10/10/2019 10:19 AM
Addresses	Billing Address	Insert	New Registration		Baptist Health Lexington 1740 Nicholasville Road Lexington, KY 40503	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		902582100	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		FL	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		003221806A	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		GA	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		610444707006	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		IL	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		01012566	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		KY	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1538244918	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		MI	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1538244918	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		10026751300	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		NE	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		Q035778	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TN	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1538244918	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		VA	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1538244918	10/10/2019 10:19 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		WV	10/10/2019 10:19 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1538244918	10/10/2019 10:19 AM
Contacts	Primary Contact	Insert	New Registration		Anderson, Michael Director of Pharmacy Baptist Health Lexington 8592606498	10/10/2019 10:19 AM
Contacts	Authorizing Official	Insert	New Registration		Sisson, Bill President Baptist Health Lexington 8592606104	10/10/2019 10:19 AM
Details	Last Recertification Date	Insert	New Registration			10/10/2019 10:19 AM
Details	Grant Number	Insert	New Registration			10/10/2019 10:19 AM
Details	340B ID	Insert	New Registration			10/10/2019 10:19 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/10/2019 10:19 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/10/2019 10:19 AM
Details	Medicare Provider Number	Insert	New Registration		180103	10/10/2019 10:19 AM
Details	Entity Name	Insert	New Registration		BAPTIST HEALTH LEXINGTON	10/10/2019 10:19 AM
Details	Program Code	Insert	New Registration		DSH	10/10/2019 10:19 AM
Details	Entity Subname	Insert	New Registration		Baptist Health Lexington Anticoagulation Clinic	10/10/2019 10:19 AM
Dates	Participating Approval Date	Insert	New Registration			10/10/2019 10:19 AM
Details	State	Insert	New Registration		Pending	10/10/2019 10:19 AM
Dates	Registration Date	Insert	New Registration		10/10/2019 10:19:07 AM	10/10/2019 10:19 AM
Dates	Signed By Date	Insert	New Registration			10/10/2019 10:19 AM
Dates	Start Date	Insert	New Registration			10/10/2019 10:19 AM
Terminations	Termination Comments	Insert	New Registration			10/10/2019 10:19 AM
Terminations	Termination Date	Insert	New Registration			10/10/2019 10:19 AM
Terminations	Termination Effective Date	Insert	New Registration			10/10/2019 10:19 AM
Terminations	Termination Reason	Insert	New Registration			10/10/2019 10:19 AM