INTREPID OF WESTERN KENTUCKY, INC. (NPI# 1811979495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811979495 |
| Entity Type | Organization |
| Organization Name | INTREPID OF WESTERN KENTUCKY, INC. |
| Other Organization Name | INTREPID USA HEALTHCARE SERVICES |
| Practice Address |
1616 Highway 121 North Suite C Murray KY 42071-0016 |
| Mailing Address |
3220 Keller Springs Rd Ste 108 Carrollton TX 75006-5911 |
| Practice Telephone | 2707531434 |
| Practice Fax Number | 2707599166 |
| Mailing Telephone | 2144453750 |
| Mailing Fax Number | 2144453902 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-02-05 |
| Authorized Official Name | PAUL M MCMULLEN (COO) |
| Authorized Official Telephone | 2144453750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 150120 | KY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 374U00000X | Home Health Aide | 150120 | KY | Nursing Service Related Providers |
| Y | 251E00000X | Home Health | 150120 | KY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 34000174 | 05 | |
| KY | 42000109 | 05 | |
| KY | 45002359 | 05 |
| Other Name | Type Code |
|---|---|
| Intrepid USA Healthcare Services | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1025 Paducah Rd, Mayfield, KY 420663615 | 2702512001 | 2702510972 |
| Street Address |
1616 HIGHWAY 121 NORTH SUITE C |
| City | MURRAY |
| State | KY |
| Zip Code | 42071-0016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356989347 | Roy Berry Mckendree | Pharmacist | 208 N 12th, Murray, KY 42071 | 2019-12-20 |
| 1629559224 | Villagemd Clinicals Pharmacy Kentucky | Pharmacy | 1000 S 12th St Ste A, Murray, KY 42071 | 2018-08-22 |
| 1205335346 | Elevation Dentistry Pllc | Dentist | 1710 Hwy 121 N. Byp. Ste A, Murray, KY 42071 | 2018-02-05 |
| 1114431715 | Devin Cassity | Specialist/Technologist | Roy Stewart Stadium Gibert Graves Drive, Murray, KY 42071 | 2017-11-20 |
| 1881146033 | Alliance Health Care, LLC | General Practice | 1710 D State Route 121 North, Murray, KY 42071 | 2016-11-03 |
| 1780039529 | Kelli Bathon | Developmental Therapist | 1988 Rowlett Trl, Murray, KY 42071 | 2016-04-29 |
| 1184060287 | William D Dewees | Veterinarian | Carman Pavilion/100 Aht Center/college Farm Road, Murray State University, Murray, KY 42071 | 2013-05-15 |
| 1467719674 | Anna Jayjock | Dentist | 700 Whitnell Avenue, Murray, KY 42071 | 2012-04-12 |
| 1629380704 | Michael James Bordieri | Psychologist | 401c Wells Hall, Murray State University, Murray, KY 42071 | 2010-07-06 |
| 1760706501 | Patrick William Thornton | Chiropractor | 408 South 12th Street, Murray, KY 42071 | 2010-03-23 |
| Find all providers in zip 42071 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174178255 | Sierra Home Health Care Slc, LLC | Home Health | 5411 S Vine St Unit 5b, Murray, UT 84107-7756 | 2019-08-06 |
| 1477939858 | Inspiration Hospice | Home Health | 835 E 4800 S Ste 110, Murray, UT 84107-5531 | 2015-08-07 |
| 1154604635 | At Home Nursing Care LLC | Home Health | 5242 College Dr Ste 210, Murray, UT 84123-2706 | 2011-09-21 |
| 1114208550 | Encompass Home Health of The West, LLC | Home Health | 990 West Bellwood Lane, Murray, UT 84123-5435 | 2011-08-30 |
| 1528261476 | Faith Littlefield Bradley | Home Health | 765 Williams Way, Murray, UT 84107-3030 | 2007-06-07 |
| 1124036249 | First Choice Home Health & Hospice Specialists Inc | Home Health | 5296 Commerce Dr, Murray, UT 84107-4767 | 2006-08-04 |
| 1528037264 | Intermountain Home Health Inc | Home Health | 5882 S 900 E, Suite 101, Murray, UT 84121-1683 | 2006-03-15 |
| 1982691853 | Jdc & Associates, Inc | Home Health | 5278 Pinemont Dr, A-120, Murray, UT 84123-2711 | 2005-10-05 |
| 1043744782 | Home Health for Utah LLC | Home Health | 5097 S 900 E Ste 100, Murray, UT 84117-5725 | 2017-04-19 |
| 1083004626 | Avamere Home Health Care, LLC | Home Health | 5965 S 900 E Ste 200, Murray, UT 84121-1854 | 2015-02-04 |
| Find all providers in MURRAY | ||||
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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.