Synergy Healthcare, PSC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SYNERGY HEALTHCARE, PSC

Practice address

330 Roland Ave
Owenton, KY 40359-1502

Phone

(859) 391-1957

NPI assigned

Jan 2, 2019

Last updated

Sep 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deepak Mittal, MDNPI 1447296538

Title

President

Phone

(859) 757-4353

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 1

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.

• Deepak Mittal, MD

  • Nephrology Physician
  • Florence, KY
  • NPI 1447296538
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1205309291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CAVALIER BLVD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410423969",
            "telephone_number": "859-757-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ROLAND AVE",
            "city": "OWENTON",
            "state": "KY",
            "postal_code": "403591502",
            "telephone_number": "859-391-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY HEALTHCARE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2022-09-30",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "MITTAL",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-757-4353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Owenton, KY
• Providers in Owenton, KY by specialty
• Substance Abuse Rehabilitation Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.