Active NPI
Samuel Joseph Cohen, CN
- Nutritionist
- Lexington, KY
National Provider Identifier
1689426504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 289418
- Practice address
- 4384 Clearwater Way Ste 190
Lexington, KY 40515-6493 - Phone
- (859) 403-3385
- NPI assigned
- Apr 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 289418 | KY | Primary |
Addresses
Primary practice location
4384 Clearwater Way Ste 190
Lexington, KY 40515-6493
Mailing address
4384 Clearwater Way Ste 190
Lexington, KY 40515-6493
Phone (859) 403-3385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 289418 | KY | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rewind Medical, LLC | Nutritionist | Current | Accepting new patients |
Locations
4384 Clearwater Way
Ste 190
Lexington, KY 40515
Phone (859) 403-3385
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712102400000",
"number": "1689426504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4384 CLEARWATER WAY STE 190",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405156493",
"telephone_number": "859-403-3385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4384 CLEARWATER WAY STE 190",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405156493",
"telephone_number": "859-403-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "SAMUEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "CN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-03",
"last_updated": "2024-04-03",
"certification_date": "2024-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "KY",
"license": "289418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.