Organization Active NPI

Neuroscience Institute of Kentucky LLC

  • Neurology Physician
  • Somerset, KY
National Provider Identifier
1316662679
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROSCIENCE INSTITUTE OF KENTUCKY LLC
Practice address
112 S Main St Ste a
Somerset, KY 42501-2063
Phone
(606) 744-1614
NPI assigned
Oct 10, 2022
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Bruce Ballet
Title
Cao
Phone
(860) 771-0622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

112 S Main St Ste a
Somerset, KY 42501-2063

Mailing address

112 S Main St Ste a
Somerset, KY 42501-2063
Phone (606) 744-1614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214002356 KY Part B Supplier - Clinic/Group Practice 3375912389 Receives reassigned benefits from 3 practitioners
Practice locations: Somerset, KY

National Provider Directory

National Provider Directory

Locations

112 S Main St
#A
Somerset, KY 42501
Phone (606) 744-1614

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1316662679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S MAIN ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012063",
            "telephone_number": "606-744-1614",
            "fax_number": "606-402-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S MAIN ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012063",
            "telephone_number": "606-744-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSCIENCE INSTITUTE OF KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "BALLET",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "860-771-0622"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 20, 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.