Impactlex, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

IMPACTLEX, LLC

Practice address

500 Horton CT
Lexington, KY 40511-1075

Phone

(859) 276-0481

Fax

(972) 616-6144

NPI assigned

Feb 12, 2019

Organization subpart

No

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

Authorized official

Name

Michael K PotterNPI 1447715677

Title

Member

Phone

(859) 489-9287

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cascades of Bluegrass Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Keith Potter

  • Developmentally Disabled Services Day Training Agency
  • Lexington, KY
  • NPI 1447715677

  Case Management

  NPD (past) Authorized official

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1700342003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HORTON CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111075",
            "telephone_number": "859-276-0481",
            "fax_number": "972-616-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HORTON CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111075",
            "telephone_number": "859-276-0481",
            "fax_number": "972-616-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACTLEX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "859-489-9287"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "7100056370",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascades of Bluegrass",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aleeza Imam
• Vida Alexandra Imani, PA-C
• Brayden Squire Imel, PA-C
• Hallea Rae Imel, DMD
• Janna L Imel, PHD
• Impromed Corp
• Maham Imran, MBBS
• In the Beginning, Inc.
• In the Scene Wellness Collective LLC
• William Barlow Inabnet III, M.D.

• Developmentally Disabled Services Day Training Agency in Lexington, KY
• Providers in Lexington, KY by specialty
• Developmentally Disabled Services Day Training Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.