Providers
JAMES DUKE, LPCC-S, LCADC
NPI 1467901496, individual, Elizabethtown, KY, Counselor, Professional
5
Evidence tier
informational
- Medicaid dollars per patient on code H0038 ($2159 per patient-month) sit in the top 5% of every provider billing that code.
score 36 of 100, rank 9880, $6.4M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JAMES DUKE, LPCC-S, LCADC |
| Type | Individual |
| Status | Active |
| NPI issued | October 3, 2016, last updated June 4, 2025 |
| Practice location | 115 PARKWAY DR, Elizabethtown, KY 42701-1012, 270-900-0373 |
| Mailing address | 725 NEW GLENDALE RD, Elizabethtown, KY 42701-8373 |
| Specialties | Counselor, Mental Health (101YM0800X, license 264409 KY) Counselor, Professional (101YP2500X, primary, license 264409 KY) Counselor, Addiction (Substance Use Disorder) (101YA0400X, license 272855 KY) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H0011 | Alcohol/drug acute detox residential per diem | $13.7M | 38% | $3K | $2K (top 5% from $4K) | 81st percentile | |
| H2027 | Psychoeducational service per 15 min | $11.0M | 30% | $4K | $161 (top 5% from $4K) | 94th percentile | |
| H0038 | Self-help/peer services per 15 min | $6.2M | 17% | $2K | $147 (top 5% from $2K) | 97th percentile | |
| H0015 | Alcohol/drug intensive outpatient per diemhistory of abuse | $2.1M | 6% | $744 | $666 (top 5% from $2K) | 58th percentile | |
| H2020 | Therapeutic behavioral services per diem | $1.3M | 4% | $1K | $455 (top 5% from $2K) | 91st percentile | |
| H2034 | Alcohol/drug halfway house services per diem | $817K | 2% | $2K | $2K (top 5% from $4K) | 43rd percentile | |
| H0035 | Mental health partial hospitalization less than 24 hours | $572K | 2% | $1K | $1K (top 5% from $3K) | 56th percentile | |
| T2023 | Medicaid service code | $403K | 1% | $365 | $332 (top 5% from $1K) | 67th percentile |
In this area
6 providers in Hardin County, KY carry an indicator in the public record, with $7.5M at stake between them. The most common is part of a provider network, on 3 of them, followed by more hours than a day holds on 2. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | RECOVERY CENTER OF KENTUCKY, LLC Elizabethtown, KY, ranked 41 | $4.5M |
|
| 3 | COMMONWEALTH OF KENTUCKY Radcliff, KY, ranked 4168 | $0 |
|
| 3 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY, ranked 5722 | $0 |
|
| 3 | HARDIN KY OPCO LLC Elizabethtown, KY, ranked 5832 | $0 |
|
| 4 | GUY LERNER Elizabethtown, KY, ranked 8563 | $3.0M |
|
| 5 | DIANNE BRADLEY Elizabethtown, KY, ranked 11644 | $92K |
Recent enforcement in KY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 27, 2026
Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges
Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.