Individual provider Active NPI

Deron Flinchum

  • Professional Counselor
  • Lexington, KY
National Provider Identifier
1609400050
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
246920 Issued in KY
Practice address
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone
(859) 253-1686
NPI assigned
Feb 25, 2020
Last updated
Feb 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 246920 KY Primary

Addresses

Primary practice location

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Mailing address

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone (859) 253-1686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607001379 KY Practitioner - Mental Health Counselor 8224570080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246920KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Vista of the Bluegrass Inc CurrentSince Apr 9, 2024 Accepting new patients
New Vista of the Bluegrass Inc CurrentSince Apr 9, 2024 Accepting new patients
New Vista of the Bluegrass Inc Current Accepting new patients

Locations

1351 Newtown Pike
Bldg 1
Lexington, KY 40511
Phone (858) 253-1686

411 Gibson Ln
Richmond, KY 40475
Phone (859) 623-9367

415 Gibson Ln
Richmond, KY 40475
Phone (859) 623-9367

438 Washington St
Stanton, KY 40380
Phone (606) 663-2274

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1609400050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLINCHUM",
        "first_name": "DERON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "246920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.