Ethos Holding Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ETHOS HOLDING CORP

Practice address

29 E 6TH St
Newport, KY 41071-1803

Phone

(513) 889-4423

NPI assigned

Nov 8, 2013

Organization subpart

Yes

Parent organization

ETHOS HOLDING CORPAs reported in NPPES

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

Authorized official

Name

Brian Kincaid

Title

Ceo/Owner

Phone

(513) 889-4423

Specialties & licenses 1

Addresses

Other names 1

• Ethos Laboratory Doing business as

Medicare fee-for-service enrollment

Enrolled in KY, MA2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Part of

Ethos Holding Corp

Locations

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1104255215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 E 6TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410711803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E 6TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410711803",
            "telephone_number": "513-889-4423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Briden St # L222",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052662",
            "country_code": "US",
            "telephone_number": "513-889-4423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ETHOS HOLDING CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ETHOS HOLDING CORP",
        "enumeration_date": "2013-11-08",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "513-889-4423"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ethos Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ethos Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.