Organization Active NPI

Healing Hands Family Medicine, LLC

  • Primary Care Clinic/Center
  • New Albany, IN
National Provider Identifier
1043861792
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALING HANDS FAMILY MEDICINE, LLC
Practice address
2676 Charlestown Rd Ste 2a
New Albany, IN 47150-2574
Phone
(812) 725-7034
NPI assigned
Sep 24, 2019
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Nichole Dawn KingNPI 1801173398
Title
FNP-BC
Phone
(812) 725-7034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

2676 Charlestown Rd Ste 2a
New Albany, IN 47150-2574

Mailing address

2676 Charlestown Rd Ste 2a
New Albany, IN 47150-2574
Phone (812) 725-7034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191206001548 IN Part B Supplier - Clinic/Group Practice 3870926751 Receives reassigned benefits from 1 practitioner
Practice locations: New Albany, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2172327Healing Hands Family Medicine, LLC2676 Charlestown Rd Suite 2a, New Albany, IN 47150Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healing Hands Family Medicine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2676 Charlestown Rd
Ste 2A
New Albany, IN 47150
Phone (410) 934-1476

2676 Charlestown Rd
Ste A
New Albany, IN 47150
Phone (930) 228-0465

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1043861792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 CHARLESTOWN RD STE 2A",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502574",
            "telephone_number": "812-725-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 CHARLESTOWN RD STE 2A",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502574",
            "telephone_number": "812-725-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HANDS FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "FNP-BC",
        "authorized_official_telephone_number": "812-725-7034"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.