JUNIPER HEALTH INC (NPI# 1467417691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467417691 |
| Entity Type | Organization |
| Organization Name | JUNIPER HEALTH INC |
| Other Organization Name | BREATHITT COUNTY FAMILY HEALTH CENTER |
| Practice Address |
1484 Lakeside Drive Jackson KY 41339-7370 |
| Mailing Address |
Po Box 690 141 Main Street Beattyville KY 41311-0690 |
| Practice Telephone | 6066669950 |
| Practice Fax Number | 6066669136 |
| Mailing Telephone | 6064640151 |
| Mailing Fax Number | 6064640152 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | DERRICK J HAMILTON (CEO) |
| Authorized Official Telephone | 6066669950 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | JUNIPER HEALTH INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
700140 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 31000854 | 05 | |
| KY | MEDICARE FQHC PTAN | 181853 | 01 |
| KY | MEDICARE PART B | 9521 | 01 |
| Other Name | Type Code |
|---|---|
| Breathitt County Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669014627 | Juniper Health Inc | Clinic/Center | 38 J F Green St, Sandy Hook, KY 41171-7134 | 2019-10-11 |
| 1316422157 | Juniper Health Inc | Clinic/Center | 672 Main St, West Liberty, KY 41472-1018 | 2018-09-27 |
| 1447791512 | Juniper Health Inc | Clinic/Center | 905 Main St, West Liberty, KY 41472-1023 | 2017-03-09 |
| 1669588505 | Juniper Health Inc | Clinic/Center | 141 Main Street, Beattyville, KY 41311 | 2006-08-22 |
| 1407818628 | Juniper Health Inc | Dentist | 125 E Main St, Beattyville, KY 41311-9249 | 2006-04-04 |
| Street Address |
1484 LAKESIDE DRIVE |
| City | JACKSON |
| State | KY |
| Zip Code | 41339-7370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396739413 | Bridget Christina Turner | Social Worker | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2005-09-02 |
| 1124488903 | Beverly Dawn Ellis | Nurse Practitioner | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2016-03-07 |
| 1871980003 | Brittany Moore Fugate | Internal Medicine | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2015-04-27 |
| 1730585035 | Samantha Sharron Lewis | Nurse Practitioner | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2014-11-13 |
| 1477818896 | Allison Michelle Manning | Nurse Practitioner | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2012-07-11 |
| 1457631780 | Jenny Faye Mullins | Family Medicine | 1484 Lakeside Drive, Jhi Breathitt County Family Health Center, Jackson, KY 41339-6555 | 2011-08-17 |
| 1174836662 | Rebecca K Smith | Social Worker | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2010-07-26 |
| 1376631283 | Derrick Jack Hamilton | Internal Medicine | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2006-10-10 |
| 1891891388 | Edgar A D Mendoza | Pediatrics | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2006-09-15 |
| 1477540086 | Kimerli Plumb-moore | Pediatrics | 1484 Lakeside Drive, Jackson, KY 41339-6555 | 2005-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
| 1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
| 1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
| 1023641446 | Andreanna Gibbs | Physical Therapy Assistant | 100 Hwy 15, Jackson, KY 41339 | 2020-02-13 |
| 1144797754 | Visionary Rehabilitation Services, LLC | Speech-Language Pathologist | 100 Kentucky Hwy 15 South, Suite 136, Jackson, KY 41339 | 2018-11-01 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| 1508225996 | Jessica Williams | Pharmacist | 842 Highway 15 N, Jackson, KY 41339 | 2016-02-15 |
| 1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
| 1265784045 | Jonathan Charles Morris | Physical Therapist | 695 Ky Hwy 15 N, Ste 3, Jackson, KY 41339 | 2012-10-04 |
| 1649539958 | Henry Price Sewell IIi IIi | Family Medicine | 170 Picnic Hill Rd, Jackson, KY 41339 | 2012-05-07 |
| Find all providers in zip 41339 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689047292 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3930 Skyview Dr, Jackson, MS 39213-5318 | 2015-11-04 |
| 1134592777 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 415 Claiborne Ave, Jackson, MS 39209-5321 | 2015-11-04 |
| 1588088025 | Southside Medical Center, Inc. | Clinic/Center | 176 Lyons St, Jackson, GA 30233-2134 | 2014-02-04 |
| 1326328311 | Rural Health Services, Inc. | Clinic/Center | 210 Atomic Rd, Jackson, SC 29831-3409 | 2011-08-22 |
| 1427377266 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 350 Woodrow Wilson Blvd, Jackson, MS 39213-4454 | 2010-05-19 |
| 1376732313 | Central Mississippi Civic Improvement Association | Clinic/Center | 1716 Isable St, Jackson, MS 39204-2352 | 2007-10-16 |
| 1447448667 | Central Mississippi Civic Improvement Association | Clinic/Center | 2185 Fortune St, Jackson, MS 39204-2333 | 2007-10-12 |
| 1205021946 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 327 S Gallatin St, Jackson, MS 39203-3514 | 2007-09-06 |
| 1598893547 | Rural Health Group, Inc. | Clinic/Center | 9409 Nc Hwy 305, Jackson, NC 27845-0594 | 2007-03-01 |
| 1023100955 | Community Action Committee of Pike County | Clinic/Center | 14590 State Route 93, Jackson, OH 45640-8977 | 2006-09-28 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.