Roaring Brook LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ROARING BROOK LLC

Practice address

600 Perimeter Dr Ste 125
Lexington, KY 40517-4296

Phone

(866) 678-8123

Fax

(877) 679-4828

NPI assigned

May 27, 2020

Organization subpart

No

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

Authorized official

Name

John A Sanders, MD

Title

Medical Doctor

Phone

(866) 678-8123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jarrod Chase, LCSW

  • Clinical Social Worker
  • Lexington, KY
  • NPI 1174065114
  Medicare reassignment Care Compare group NPD
• Kelsey Hess

  • Professional Counselor
  • Lexington, KY
  • NPI 1386129823
  Medicare reassignment Care Compare group NPD
• Hillary Nolan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
  • NPI 1619670478
  Medicare reassignment Care Compare group NPD
• Matthew Nicholas Otto, TCADC

  • Counselor
  • Lexington, KY
  • NPI 1053907634
  Medicare reassignment Care Compare group NPD
• Laurel Olivia Yoder

  • Professional Counselor
  • Lexington, KY
  • NPI 1750016408
  Medicare reassignment NPD
• Vahid Osman, MD

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1740264720

  KY

  Medicare reassignment NPD
• David Thomas, LCADC

  • Counselor
  • Lexington, KY
  • NPI 1225492762
  NPD
• Tiffany Tucker Dobbs, LPCC

  • Counselor
  • Lexington, KY
  • NPI 1881284628
  NPD (past)

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1053934836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PERIMETER DR STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174296",
            "telephone_number": "866-678-8123",
            "fax_number": "877-679-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PERIMETER DR STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174296",
            "telephone_number": "866-678-8123",
            "fax_number": "877-679-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROARING BROOK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "866-678-8123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RLL Anesthesia PLLC
• Peyton Talichet Roach, MD
• Andrew Russell Roads, M.D.
• Mary Elise Roads, PHARMD
• Clarissa Renee Roan-Belle
• Mary Charise Roark
• Shane Alan Roark
• Susan Kay Roark
• Tabitha Roark
• Tina L Roark, RPH

• Substance Use Disorder Rehabilitation Clinic/Center in Lexington, KY
• Providers in Lexington, KY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.