COMMONWEALTH OF KENTUCKY (NPI# 1770762833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770762833 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Practice Address |
5659 Main St Thelma KY 41260-8609 |
| Practice Telephone | 6067886600 |
| Practice Fax Number | 6067887076 |
| Mailing Telephone | 6067886600 |
| Mailing Fax Number | 6067887076 |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2010-06-30 |
| Authorized Official Name | MRS. GAYLENE MORROW (BILLING CLERK) |
| Authorized Official Telephone | 6067886600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686900 | Commonwealth of Kentucky | Skilled Nursing Facility | 100 Veterans Drive, Radcliff, KY 40160 | 2015-08-14 |
| 1245657857 | Commonwealth of Kentucky | Clinic/Center | 2441 Us Highway 27, Somerset, KY 42501 | 2014-03-20 |
| 1730329897 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood, 2441 S. Hwy 27, Somerset, KY 42501 | 2009-03-03 |
| 1588804546 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood Dr, 2441 S. Hwy 27, Somersetq, KY 42501 | 2009-03-03 |
| 1396962551 | Commonwealth of Kentucky | Nursing Facility/Intermediate Care Facility | 200 Veterans Dr, Hazard, KY 41701-9484 | 2007-04-19 |
| 1124144456 | Commonwealth of Kentucky | Pharmacy | 2400 Russellville Road, Hopkinsville, KY 42240 | 2007-03-21 |
| 1194862599 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 23524 Dawson Springs Rd, Dawson Springs, KY 42408-9205 | 2007-02-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1689652513 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 210 Meadows Dr, Mt Washington, KY 40047-6013 | 2005-12-30 |
| 1306824230 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 9001 Park Wood Dr, Crestwood, KY 40014-9499 | 2005-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMONWEALTH OF KENTUCKY - DEPARTMENT FOR LOCAL GOVERNMENT | 1024 Capital Center Dr Ste 340, Frankfort, KY 40601-7514 |
| Street Address |
5659 MAIN ST |
| City | THELMA |
| State | KY |
| Zip Code | 41260-8609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407089857 | Sandra Gail Reynolds | Speech-Language Pathologist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-02 |
| 1104059575 | Sherry Le Ann Prater | Speech-Language Pathologist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1689807042 | Susan Marie Miller | Occupational Therapist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1912130477 | Kathalene Casebolt Barlow | Occupational Therapist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1215160767 | Alisa Marie Gound | Occupational Therapist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1538392998 | Melissa Kay Hall | Occupational Therapist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1295968659 | Robin Barker O'bryan | Physical Therapist | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| 1750514212 | Mona Kaye Daniel | Physical Therapy Assistant | 5659 Main St, Thelma, KY 41260-8609 | 2009-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902039639 | Barbara Ann Pugh | Speech-Language Pathologist | 5659 Main Street, Thelma, KY 41260 | 2009-08-28 |
| 1124251582 | Amanda Elaine Tackett | Physical Therapy Assistant | 5659 Main Street, Thelma, KY 41260 | 2009-09-01 |
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689050916 | Victoria's Dream, LLC | Residential Treatment Facility, Physical Disabilities | 8345 Bloomfield Rd, Bloomfield, KY 40008-7000 | 2015-08-10 |
| 1174958474 | Heavenly Angel Wings Retirement Home | Residential Treatment Facility, Physical Disabilities | 8404 Knifley Rd, Columbia, KY 42728-7505 | 2013-09-05 |
| 1871841114 | Premier Therapy Care | Residential Treatment Facility, Physical Disabilities | 330 Eastern Byp, Suite 145, Richmond, KY 40475-2562 | 2012-08-16 |
| 1154341923 | Masonic Homes of Kentucky Inc | Residential Treatment Facility, Physical Disabilities | 240 Masonic Home Dr, Masonic Home, KY 40041-9000 | 2006-07-21 |
| 1497256770 | New Vista Behavioral Healthcare Inc. | Residential Treatment Facility, Physical Disabilities | 1351 Newtown Pike Bldg 1, Lexington, KY 40511-1277 | 2018-02-22 |
| 1366810434 | Rehabcare Group East Inc. | Residential Treatment Facility, Physical Disabilities | 680 S 4th St, Louisville, KY 40202-2407 | 2015-09-08 |
| 1962776443 | Sundance Rehabilitation | Residential Treatment Facility, Physical Disabilities | 7300 Woodspoint Drive, Florence, KY 41042 | 2012-03-01 |
| 1619013901 | Eldridge-keelin Chiropractic Pllc | Residential Treatment Facility, Physical Disabilities | 1320 Wolohan Dr, Ashland, KY 41102-8940 | 2007-01-30 |
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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.