Providers

CORI CARTER DOUGLAS, MSW, LCSW

NPI 1841348356, individual, Owensboro, KY, Social Worker, Clinical

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 3 months under one organization, which can be supervisory billing.
  • Records needed.
score 51 of 100, rank 9022, $895K at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Feb 2018More hours than a day holds, even counting one unit per claim line25.022.014.720.6314190791 90832 90834 90837 99354$39K
Jul 2018More hours than a day holds, even counting one unit per claim line24.822.214.820.8315190791 90832 90834 90837 99354$43K
Aug 2018More hours than a day holds, even counting one unit per claim line25.123.215.520.8321190791 90832 90834 90837 99354$45K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameCORI CARTER DOUGLAS, MSW, LCSW
TypeIndividual
StatusActive
NPI issuedJanuary 8, 2007, last updated July 2, 2015
Practice location2720 FREDERICA ST, Owensboro, KY 42301-5442, 270-926-2484
Specialties
Social Worker, Clinical (1041C0700X, primary, license 3423 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
T2023Medicaid service code$833K42%$330$332 (top 5% from $1K)49th percentile
90837Psychotherapy, 1 hourhistory of abuse$736K37%$170$191 (top 5% from $442)40th percentile
99354Prolonged service outpatient first hour (retired 2023)$229K12%$120$78 (top 5% from $222)72nd percentile
H0032Medicaid service code$62K3%$63$98 (top 5% from $675)23rd percentile
90832Psychotherapy, 30 minutes$52K3%$58$59 (top 5% from $239)49th percentile
90834Psychotherapy, 45 minutes$36K2%$60$101 (top 5% from $318)24th percentile
90791Psychiatric diagnostic evaluation$31K2%$72$105 (top 5% from $228)27th percentile
90887Medicaid service code$1K0%$59$98 (top 5% from $270)too few months to rank

In this area

3 providers in Daviess County, KY carry an indicator in the public record, with $103K at stake between them. The most common is paid after a public list action, on 1 of them, followed by part of a provider network on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1MICHAEL DUGGER
Owensboro, KY, ranked 317
$5K
  • Listed on the KY Medicaid exclusion list since September 25, 2023.
  • Medicaid still paid claims in 5 later months, $5,493 in total.
3WELLINGTON PARC HEALTH SYSTEMS, INC.
Owensboro, KY, ranked 4394
$0
  • Part of provider network D1-00059, ranked 59 nationally.
5TRAVIS MORRISON
Owensboro, KY, ranked 11631
$98K

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

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.

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