NPIMap

Organization Active NPI

Northern Kentucky Mental Health Mental Retardation Regional Board

  • Case Management Agency
  • Covington, KY
National Provider Identifier
1295937134
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
800084 Issued in KY
Legal business name
NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD
Practice address
503 Farrell Drive
Covington, KY 41011
Phone
(859) 578-3200
Fax
(859) 578-3273
NPI assigned
Jun 4, 2007
Organization subpart
Yes
Parent organization
NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Owen T Nichols, PSY.D
Title
Ceo
Phone
(859) 578-3252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 800084 KY Primary

Addresses

Primary practice location

503 Farrell Drive
Covington, KY 41011

Mailing address

503 Farrell Drive
Covington, KY 41011
Phone (859) 578-3200

Other identifiers 1

IdentifierTypeStateIssuer
27007012MedicaidKY

Other names 1

  • Northkey Community Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northern Ky Comp Care9 organizations share this tax ID, including this one
Part of
Northern Ky Comp Care

Other organizations with this tax ID 8

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

Locations

503 Farrell Dr
Covington, KY 41011
Phone (606) 578-3214

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1295937134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 FARRELL DRIVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "859-578-3200",
            "fax_number": "859-578-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 FARRELL DRIVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "859-578-3200",
            "fax_number": "859-578-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD",
        "enumeration_date": "2007-06-04",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-578-3252",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": "800084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27007012",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northkey Community Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.