New Life Clinic, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

NEW LIFE CLINIC, LLC

Practice address

506 N Main St
Nicholasville, KY 40356

Phone

(859) 887-3712

Fax

(859) 887-2926

NPI assigned

Nov 1, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jack Kendrick, MD

Title

Program Director

Phone

(859) 887-3712

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502928000000",
    "number": "1356695100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 N MAIN ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356",
            "telephone_number": "859-887-3712",
            "fax_number": "859-887-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N MAIN ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356",
            "telephone_number": "859-887-3712",
            "fax_number": "859-887-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2017-08-17",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "859-887-3712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.