Intrepid of Kentucky, Inc.

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

Legal business name

INTREPID OF KENTUCKY, INC.

Practice address

2411 Ring Rd Ste 106
Elizabethtown, KY 42701-5930

Phone

(270) 763-9242

NPI assigned

Aug 5, 2021

Organization subpart

No

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

Authorized official

Name

Robert Parker, CCO

Title

Chief Compliance Officer

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other names 1

• Intrepid Palliative & Supportive Care Doing business as

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1407520158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 KELLER SPRINGS RD STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750065911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 RING RD STE 106",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015930",
            "telephone_number": "270-763-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID OF KENTUCKY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_credential": "CCO"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intrepid Palliative & Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hospice and Palliative Medicine (Family Medicine) Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.