NPIMap

Organization Active NPI

Wild Health, Inc.

  • Primary Care Clinic/Center
  • Lexington, KY
National Provider Identifier
1174133441
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WILD HEALTH, INC.
Practice address
535 Wellington Way Ste 330
Lexington, KY 40503-1331
Phone
(859) 439-0400
Fax
(859) 439-0399
NPI assigned
Aug 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Ryan Miller, PA-CNPI 1497034052
Title
VP of Clinical of Operations
Phone
(859) 439-0400

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetics Clinic/Center 261QG0250X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

535 Wellington Way Ste 330
Lexington, KY 40503-1331

Mailing address

535 Wellington Way Ste 330
Lexington, KY 40503-1331
Phone (859) 439-0400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1174133441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331",
            "telephone_number": "859-439-0400",
            "fax_number": "859-439-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 WELLINGTON WAY STE 330",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031331",
            "telephone_number": "859-439-0400",
            "fax_number": "859-439-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VP OF CLINICAL OF OPERATIONS",
        "authorized_official_telephone_number": "859-439-0400",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.