Organization Active NPI

Grant County Wellness Center LLC

  • Pain Clinic/Center
  • Dry Ridge, KY
National Provider Identifier
1164713103
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
0788501.06 Issued in KY
Legal business name
GRANT COUNTY WELLNESS CENTER LLC
Practice address
99 S. Main St.
Dry Ridge, KY 41035
Phone
(859) 325-5655
Fax
(859) 823-0530
NPI assigned
Apr 25, 2011
Last updated
Sep 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Mr. Ernest William Singleton
Title
R.N./C.O.O.
Phone
(859) 325-5655

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X 0788501.06 KY Primary
Anesthesiology Physician 207L00000X 26944 NU

Addresses

Primary practice location

99 S. Main St.
Dry Ridge, KY 41035

Mailing address

99 S. Main St.
Dry Ridge, KY 41035
Phone (859) 325-5655

Other identifiers 1

IdentifierTypeStateIssuer
208VP0000XOtherKYTAXONOMY

National Provider Directory

National Provider Directory

Locations

99 S Main St
Dry Ridge, KY 41035
Phone (859) 785-5717

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1164713103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 S. MAIN ST.",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "41035",
            "telephone_number": "859-325-5655",
            "fax_number": "859-823-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 S. MAIN ST.",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "41035",
            "telephone_number": "859-325-5655",
            "fax_number": "859-823-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT COUNTY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "R.N./C.O.O.",
        "authorized_official_telephone_number": "859-325-5655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "KY",
            "license": "0788501.06",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": "26944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "208VP0000X",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dry Ridge, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.