Kentucky Addiction Centers London

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KENTUCKY ADDICTION CENTERS LONDON

Practice address

1380 Highway 192 E
London, KY 40741-3123

Phone

(606) 385-3960

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Trouper Krueger

Title

Cso-HHR

Phone

(979) 324-5456

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1578159232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 HIGHWAY 192 E",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 HIGHWAY 192 E",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413123",
            "telephone_number": "606-385-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY ADDICTION CENTERS LONDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "TROUPER",
        "authorized_official_title_or_position": "CSO-HHR",
        "authorized_official_telephone_number": "979-324-5456"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in London, KY
• Providers in London, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.