Providers

ZIA NEUROLOGY ASSOCIATES, LLC

NPI 1730652785, organization, Bowling Green, KY, Psychiatry & Neurology, Neurology

1
Evidence tier
documented action, then payment
  • Listed on the KY Medicaid exclusion list since October 5, 2020.
  • Medicaid still paid claims in 3 later months, $8,176 in total.
score 94 of 100, rank 299, $8K at stake

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
KY Medicaid exclusion list
state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap)
Exact NPI, name verifiedOct 5, 2020still open3Nov 2020Jan 2021$8K$256K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameZIA NEUROLOGY ASSOCIATES, LLC
TypeOrganization
StatusActive
NPI issuedJanuary 2, 2019, last updated May 20, 2020
Practice location523 PARK ST, Bowling Green, KY 42101-1765, 270-393-8418
Authorized officialJOYCE YOUNG (Billing Specialist)
Specialties
Nurse Practitioner (363L00000X)
Psychiatry & Neurology, Neurology (2084N0400X, primary)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$47K18%$33$60 (top 5% from $133)too few months to rank
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$29K11%$24$44 (top 5% from $110)too few months to rank
95816Measurement of brain wave activity (eeg), awake and drowsy$23K9%$88$63 (top 5% from $334)too few months to rank
95913Nerve conduction, 13 or more studies$19K7%$170$189 (top 5% from $312)too few months to rank
95912Nerve conduction, 11-12 studies$19K7%$154$164 (top 5% from $289)too few months to rank
95957Measurement of brain wave activity (eeg), digital analysis$19K7%$69$105 (top 5% from $271)too few months to rank
95886Needle measurement of electrical activity in arm or leg muscles, complete study$18K7%$134$81 (top 5% from $202)too few months to rank
76942Ultrasonic guidance for needle placement$17K6%$64$31 (top 5% from $114)too few months to rank

In this area

6 providers in Warren County, KY carry an indicator in the public record, with $10.8M at stake between them. The most common is more hours than a day holds, on 4 of them, followed by paid after a public list action on 1. 2 are tier 1: documented action, then payment.

tierproviderat stakewhy
1THOMAS HUGHES
Bowling Green, KY, ranked 121
$152K
  • Listed on the IN Medicaid exclusion list since November 30, 2016.
  • Medicaid still paid claims in 42 later months, $151,689 in total.
1ACCULAB, LLC
Bowling Green, KY, ranked 278
$12K
  • Adjudicated (civil judgment) per an HHS-OIG enforcement record dated January 30, 2024.
  • Medicaid paid $11,586 in the last 12 observed months.
4MICHELLE CONNER
Bowling Green, KY, ranked 8479
$3.7M
  • Hours beyond a day in 7 months, but with up to 1491 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4KIMBERLY WILSON
Bowling Green, KY, ranked 8616
$2.6M
  • Hours beyond a day in 3 months under one organization, which can be supervisory billing.
  • Records needed.
4KRISTINA FULLER
Bowling Green, KY, ranked 8632
$2.5M
  • Hours beyond a day in 31 months, but with up to 754 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5EMILY EDWARDS
Bowling Green, KY, ranked 10829
$1.9M

Recent enforcement in KY

All releases

Department 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

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