NPIMap

Organization Active NPI

Nautilus Health Care Group, PLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Somerset, KY
National Provider Identifier
1164866877
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
NAUTILUS HEALTH CARE GROUP, PLC
Practice address
353 Bogle St
Somerset, KY 42503-2888
Phone
(606) 451-3820
Fax
(606) 451-3862
NPI assigned
Apr 24, 2013
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
David Bassin
Title
Ceo
Phone
(855) 689-5105

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X NU
Internal Medicine Physician 207R00000X NU
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU Primary
Surgery Physician 208600000X NU

Addresses

Primary practice location

353 Bogle St
Somerset, KY 42503-2888

Mailing address

5220 Belfort Rd Ste 130
Jacksonville, FL 32256-6018
Phone (904) 446-3451

Other practice location 1

1000 Ashland Dr Ste G1
Ashland, KY 41101-7084
Phone (606) 833-4043

Other identifiers 1

IdentifierTypeStateIssuer
7100349080MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130913000649 KY Part B Supplier - Clinic/Group Practice 4183868052 Receives reassigned benefits from 25 practitioners
Practice locations: Somerset, KY; Madisonville, KY; Frankfort, KY; Louisville, KY; La Grange, KY; Fort Thomas, KY; Ashland, KY

National Provider Directory

National Provider Directory

Locations

1000 Ashland Dr
Ste G1
Ashland, KY 41101
Phone (606) 833-4043

353 Bogle St
Somerset, KY 42503
Phone (606) 451-3820

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1164866877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566018",
            "telephone_number": "904-446-3451",
            "fax_number": "904-446-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 BOGLE ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032888",
            "telephone_number": "606-451-3820",
            "fax_number": "606-451-3862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Ashland Dr Ste G1",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411017084",
            "country_code": "US",
            "telephone_number": "606-833-4043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NAUTILUS HEALTH CARE GROUP, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "BASSIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-689-5105"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100349080",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.