Jared Tyler Adams
Individual provider Active NPI Peer Specialist · Louisa, KY
NPI 1043889751 · NPPES record last updated Jun 18, 2021
Key facts
- NPI
- 1043889751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 125 S Main Cross St
Louisa, KY 41230-1065 - Phone
- (606) 638-0938
- NPI assigned
- Jun 18, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
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) 638-0938
Other providers in Louisa, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.