Kentucky Phoenix Project LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

KENTUCKY PHOENIX PROJECT LLC

Practice address

5230 Ky Route 321 Ste 6
Prestonsburg, KY 41653-9169

Phone

(606) 459-5001

Fax

(606) 548-5477

NPI assigned

Sep 13, 2023

Last updated

Nov 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Casey CollierNPI 1780157578

Title

Coo

Phone

(606) 471-4546

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Casey Collier

  • Community Health Worker
  • Prestonsburg, KY
  • NPI 1780157578
  NPD Authorized official
• Danny Smith

  • Community Health Worker
  • Pikeville, KY
  • NPI 1770358327
  NPD

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1639956527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530126",
            "telephone_number": "606-459-5001",
            "fax_number": "606-548-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 KY ROUTE 321 STE 6",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539169",
            "telephone_number": "606-459-5001",
            "fax_number": "606-548-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY PHOENIX PROJECT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "606-471-4546"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentucky Em-I Medical Services, PSC
• Kentucky Laparoscopic & Advanced Surgical Specialists, PLLC
• Kentucky Mountain Emergency Physicians
• Kentucky Pain Physicians (Robert E Windsor MD)
• Kentucky Pain Physicians, PSC
• Kentucky Surgical Arts PSC
• Heather Kestner
• Jeffery Kestner
• Lisa Kestner
• Jewel Keys

• Substance Use Disorder Rehabilitation Clinic/Center in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.