COMMONWEALTH OF KENTUCKY (NPI# 1790816395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790816395 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | EASTERN STATE HOSPITAL |
| Practice Address |
1350 Bull Lea Rd Lexington KY 40511-1247 |
| Practice Telephone | 8592468000 |
| Practice Fax Number | 8592468043 |
| Mailing Telephone | 8592468000 |
| Mailing Fax Number | 8592468043 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2015-07-07 |
| Authorized Official Name | STEPHANIE CRAYCRAFT (DIRECTOR) |
| Authorized Official Telephone | 5027826243 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMONWEALTH OF KENTUCKY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
P06579 | KY | Suppliers |
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| Y | 283Q00000X | Psychiatric Hospital | KY | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 02020030 | 05 |
| Other Name | Type Code |
|---|---|
| Eastern State Hospital | Doing Business As Name - Organization |
| 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 |
| 1770762833 | Commonwealth of Kentucky | Residential Treatment Facility, Physical Disabilities | 5659 Main St, Thelma, KY 41260-8609 | 2007-10-25 |
| 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 |
| 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 |
1350 BULL LEA RD |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40511-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922067677 | Jinny Rae Woodcock | Registered Nurse | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2006-03-21 |
| 1043822810 | Caitlin Crowder | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2020-08-21 |
| 1811508849 | Charley Renee Saleeby | Nurse Practitioner | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2020-08-13 |
| 1841843844 | Katibeth Sharp | Psychologist | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2019-07-18 |
| 1508320078 | Haley Herndon | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2019-01-29 |
| 1730607722 | Thomas J Shaddix | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2017-08-30 |
| 1790200525 | Paige Kelly Juettner | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2017-08-14 |
| 1972054443 | Commonwealth of Kentucky | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-10-20 |
| 1326599895 | Commonwealth of Kentucky | Nurse Practitioner | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-10-20 |
| 1750831574 | Lauren M Greenman | Physician Assistant | 1350 Bull Lea Rd, Lexington, KY 40511-1247 | 2016-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278915 | Amy H Ward | Counselor | 1382 Bull Lea Road, Lexington, KY 40511 | 2019-01-03 |
| 1295233104 | Coventry Oak Elementary School | Public Health or Welfare | 2441 Huntly Place, Lexington, KY 40511 | 2018-01-25 |
| 1881192789 | The Stables (school) | Public Health or Welfare | 4089 Iron Works Pike, Lexington, KY 40511 | 2018-01-25 |
| 1124526033 | Garrett Morgan Elementary School | Public Health or Welfare | 1150 Passage Mound Way, Lexington, KY 40511 | 2018-01-25 |
| 1760903520 | Taylor Bowman | Optometrist | 2500 Leestown Road, Lexington, KY 40511 | 2017-07-03 |
| 1982134409 | Amy Beth Powers | Counselor | 455 Park Place, Suite 130, Lexington, KY 40511 | 2017-06-18 |
| 1336695196 | Life Navigation Services, LLC | Community/Behavioral Health | 348 Mcconnells Trace #102, Lexington, KY 40511 | 2016-08-31 |
| 1730545989 | Delmetria Cayson Combs | Counselor | 1374 Bull Lea Road, Lexington, KY 40511 | 2016-01-04 |
| 1720456080 | Lisa Higgins | Case Manager/Care Coordinator | 1351 Newtown Pike #5, Bluegrass, Lexington, KY 40511 | 2015-09-03 |
| 1346500766 | Rachel Elaine Clark | Counselor | 1351 Newtown Pike, Bldg 4, Lexington, KY 40511 | 2012-05-18 |
| Find all providers in zip 40511 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801823828 | Bluegrass Regional Psychiatric Services Inc. | Psychiatric Hospital | 627 W Fourth St, Lexington, KY 40508-1294 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548201379 | Green River Regional Mental Health/mental Retardation Board, Inc. | Psychiatric Hospital | 1000 Industrial Dr, Owensboro, KY 42301-8715 | 2006-06-10 |
| 1366447609 | Central State Hospital | Psychiatric Hospital | 10510 Lagrange Rd, Louisville, KY 40223-1277 | 2005-06-14 |
| 1417486325 | Northern Kentucky Behavioral, LLC | Psychiatric Hospital | 820 Dolwick Drive, Erlanger, KY 41018 | 2017-06-06 |
| 1275953754 | Tbd Acquisition, LLC | Psychiatric Hospital | 1405 Browns Ln, Louisville, KY 40207-4608 | 2014-04-23 |
| 1700023918 | St Claire Regional | Psychiatric Hospital | 222 Medical Cir, Morehead, KY 40351-1179 | 2009-01-09 |
| 1952506008 | United Healtcare of Hardin | Psychiatric Hospital | 3909 S Wilson Rd, Radcliff, KY 40160-8944 | 2007-06-19 |
| 1417167131 | Caritas Peace Center | Psychiatric Hospital | 2020 Newburg Rd, Louisville, KY 40205-1803 | 2007-05-23 |
| 1124237375 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Hospital | 2020 Newburg Rd, Louisville, KY 40205-1803 | 2007-05-22 |
| 1316003361 | Green River Regional Mental Health/mental Retardation Board, Inc. | Psychiatric Hospital | 1000 Industrial Dr, Owensboro, KY 42301-8715 | 2006-12-27 |
| 1265530034 | Central State Hospital Pharmacy | Psychiatric Hospital | 10510 Lagrange Rd, Louisville, KY 40223-1277 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
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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.