Berea College Health Service

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

23321 Issued in KY

Legal business name

BEREA COLLEGE HEALTH SERVICE

Practice address

305 Estill St
Berea, KY 40403-1742

Phone

(859) 985-3212

Fax

(859) 985-3910

NPI assigned

Oct 27, 2006

Last updated

Nov 29, 2023By 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

Mrs. Dorothy Eileen Mau

Title

Office Manager

Phone

(859) 985-3212

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1346326774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-985-3212",
            "fax_number": "859-985-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-985-3212",
            "fax_number": "859-985-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEREA COLLEGE HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "MAU",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "859-985-3212",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "23321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOAN MOORE, ARNP",
            "identifier": "1353P",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beh Physical Therapy
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• Berea Health Care, Inc.
• Berea Health Ministry, Inc
• Berea Healthcare, LLC (Berea Acquisition, LLC)

• Student in an Organized Health Care Education/Training Program in Berea, KY
• Providers in Berea, KY by specialty
• Student in an Organized Health Care Education/Training Program in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.