NPIMap

Organization Active NPI

Telos Health Systems Ky LLC

  • Mental Health Counselor
  • Louisville, KY
National Provider Identifier
1629600879
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TELOS HEALTH SYSTEMS KY LLC
Practice address
3500 Good Samaritan Way
Louisville, KY 40299-6117
Phone
(201) 217-6777
NPI assigned
Feb 6, 2020
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Peter Steven Bailey
Title
Ceo
Phone
(609) 480-0119

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X
Internal Medicine Physician 207R00000X
Physician Assistant 363A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

3500 Good Samaritan Way
Louisville, KY 40299-6117

Mailing address

980 Sylvan Ave FL 2
Englewood Cliffs, NJ 07632-3320
Phone (201) 217-6777

Other names 1

  • Vitae Health Medical Kentucky LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200403001181 KY Part B Supplier - Clinic/Group Practice 3173952637 Receives reassigned benefits from 49 practitioners
Practice locations: Hopkinsville, KY; Williamstown, KY; Russellville, KY; Princeton, KY; Paducah, KY; Owenton, KY; Mayfield, KY; Louisville, KY…

National Provider Directory

National Provider Directory

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

107 Boyles Dr
Russellville, KY 42276
Phone (270) 726-9049

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1629600879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SYLVAN AVE FL 2",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323320",
            "telephone_number": "201-217-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GOOD SAMARITAN WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996117",
            "telephone_number": "201-217-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELOS HEALTH SYSTEMS KY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-480-0119"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitae Health Medical Kentucky LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.