Harbor of Hope Medical and Behavioral Health Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC

Practice address

185 Treuhaft Blvd Apt 4
Barbourville, KY 40906-8300

Phone

(606) 545-6766

NPI assigned

Nov 11, 2019

Last updated

Apr 13, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Thelma J Gray, APRNNPI 1548755499

Title

Owner

Phone

(606) 269-3428

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Tax ID family

Harbor of Hope Medical and Behavioral Health Care LLC3 organizations share this tax ID, including this one

Part of

Harbor of Hope Medical and Behavioral Health Care LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Harbor of Hope Medical and Behavioral Health Care, LLC

  • Professional Counselor
  • Barbourville, KY
  • NPI 1134738412
  NPD tax ID
• Harbor of Hope Medical and Behavioral Health Care, LLC

  • Psychiatry Physician
  • Barbourville, KY
  • NPI 1639875693
  NPD tax ID

Practitioners 2

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.

• Thelma Jean Gray, APRN

  • Family Nurse Practitioner
  • Barbourville, KY
  • NPI 1548755499
  Medicare reassignment Care Compare group NPD Authorized official
• Brittney Nichole Saylor, MA

  • Mental Health Counselor
  • Somerset, KY
  • NPI 1407197627

  Professional

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1235774522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 SAM PARKER RD",
            "city": "GRAY",
            "state": "KY",
            "postal_code": "407346780",
            "telephone_number": "606-269-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TREUHAFT BLVD APT 4",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409068300",
            "telephone_number": "606-545-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARBOR OF HOPE MEDICAL AND BEHAVIORAL HEALTH CARE, LLC",
        "enumeration_date": "2019-11-11",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "THELMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-269-3428",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100615630",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Dawn Hamilton, LPCA
• Deborah Ann Hammond, R.D.
• George F. Hammons, RPH
• Paul Thomas Haney, MD
• Harbor of Hope Medical and Behavioral Health Care, LLC
• Harbor of Hope Medical and Behavioral Health Care, LLC
• Sydney Raquel Harris
• Syed Kamran Hasni, MD
• David Aaron Hatfield, DO
• Connie D Hauser, PT, ATC, DPT

• Family Nurse Practitioner in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.