Paintsville Behavioral Health, Inc

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

PAINTSVILLE BEHAVIORAL HEALTH, INC

Practice address

236 College St
Paintsville, KY 41240-1098

Phone

(606) 367-5569

NPI assigned

Apr 6, 2022

Organization subpart

No

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

Authorized official

Name

Jordan Pelfrey

Title

Ceo

Phone

(606) 367-5569

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Paintsville Behavioral Health, Inc

  • Clinical Social Worker
  • Hopkinsville, KY
  • NPI 1861260788

  O20220701000549

  Same enrollment

Tax ID family

Paintsville Behavioral Health Inc2 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.

• Paintsville Behavioral Health, Inc

  • Clinical Social Worker
  • Hopkinsville, KY
  • NPI 1861260788
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Paintsville Behavioral Health, Inc

  • Clinical Social Worker
  • Hopkinsville, KY
  • NPI 1861260788
  NPPES parent name

Practitioners 3

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

• Jimmy Dean Salyers Jr., LCSW

  • Clinical Social Worker
  • Hopkinsville, KY
  • NPI 1710624820
  Medicare reassignment NPD
• Lori Humphries, LCSW

  • Clinical Social Worker
  • Prestonsburg, KY
  • NPI 1922423763
  NPD (past)
• John Kevin Schmidt Jr., LPCC, LCADC

  • Mental Health Counselor
  • Bardstown, KY
  • NPI 1760089254
  NPD (past)

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1083355424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 COLLEGE ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401098",
            "telephone_number": "606-367-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 COLLEGE ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401098",
            "telephone_number": "606-367-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINTSVILLE BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "PELFREY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-367-5569"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Ann Omer, PT
• Optimum Wellness Center
• Clayton Thomas Osborne
• Barbara Sue Ousley, BA, CADC, CSS
• Phillip E Pack, M.S.
• Paintsville Dental Center
• Paintsville Emergency Group LLC
• Paintsville High School
• Paintsville Hma Physician Management, LLC
• Paintsville Hma Physician Mangament

• Psychiatric/Mental Health Registered Nurse in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Psychiatric/Mental Health Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.