Luminosity Integrated Rejuvenation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LUMINOSITY INTEGRATED REJUVENATION

Practice address

503 Depot Road
Paintsville, KY 41240

Phone

(606) 793-5077

NPI assigned

Mar 28, 2024

Organization subpart

No

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

Authorized official

Name

Jason Short, APRNNPI 1659813301

Title

Owner

Phone

(606) 793-5077

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 1

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

• Jason Scott Short, APRN

  • Family Nurse Practitioner
  • Paintsville, KY
  • NPI 1659813301
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1073364170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "STAFFORDSVILLE",
            "state": "KY",
            "postal_code": "412560055",
            "telephone_number": "606-793-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 DEPOT ROAD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "41240",
            "telephone_number": "606-793-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOSITY INTEGRATED REJUVENATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-793-5077",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratory Corporation of America
• Hope Lafferty
• Christopher Laney
• Teresa Ann Lawson, APRN
• Gary A. Lowther, D.O.
• LV Behavioral
• Mark P Caruso MD
• Leigh Ann Marquez, SLP
• Jennifer Lynn Martin, APRN FNP-C
• Laura Martin, LPCC

• Primary Care Clinic/Center in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.