NPIMap

Organization Active NPI

Pioneer Health Group LLC

  • Addiction Medicine (Family Medicine) Physician
  • Louisa, KY
National Provider Identifier
1023691599
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PIONEER HEALTH GROUP LLC
Practice address
125 S Main Cross St
Louisa, KY 41230-1065
Phone
(606) 639-0938
Fax
(859) 813-5394
NPI assigned
May 3, 2021
Organization subpart
Yes
Parent organization
PIONEER HEALTH GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Victor A Orlov
Title
Director of Credentialing
Phone
(606) 638-0938

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

125 S Main Cross St
Louisa, KY 41230-1065

Mailing address

125 S Main Cross St
Louisa, KY 41230-1065
Phone (606) 639-0938

National Provider Directory

National Provider Directory
Tax ID family
Beth'S Blessing5 organizations share this tax ID, including this one
Part of
Beth'S Blessing

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1023691599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-639-0938",
            "fax_number": "859-813-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-639-0938",
            "fax_number": "859-813-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIONEER HEALTH GROUP, LLC",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "ORLOV",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "606-638-0938"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.