Organization Active NPI

Rhema of Fox Valley

  • Multi-Specialty Clinic/Center
  • Louisville, KY
National Provider Identifier
1114637667
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RHEMA OF FOX VALLEY
Practice address
1467 S 9TH St
Louisville, KY 40208-2254
Phone
(502) 498-0908
NPI assigned
Nov 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Cameron D BrownNPI 1144948274
Title
Owner/Ceo
Phone
(920) 252-9024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
Substance Abuse Rehabilitation Facility 324500000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1467 S 9TH St
Louisville, KY 40208-2254

Mailing address

1705 Crystal Springs Ave
Oshkosh, WI 54902-6122
Phone (920) 252-9024

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1114637667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CRYSTAL SPRINGS AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026122",
            "telephone_number": "920-252-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 S 9TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402082254",
            "telephone_number": "502-498-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHEMA OF FOX VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "920-252-9024"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.