Organization Active NPI

Panacea Healthcare

  • Addiction Medicine (Family Medicine) Physician
  • Frankfort, KY
National Provider Identifier
1700541646
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PANACEA HEALTHCARE
Practice address
140 Kings Daughters Drive Suite 400
Frankfort, KY 40601
Phone
(502) 699-2885
Fax
(502) 699-2890
NPI assigned
Nov 4, 2021
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Dennis Louis Hall, LADC, CADC, CCSNPI 1972121838
Title
Owner
Phone
(502) 229-4017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Addiction Medicine (Family Medicine) Physician 207QA0401X Primary
Case Manager/Care Coordinator 171M00000X
Addiction Medicine (Preventive Medicine) Physician 2083A0300X

Addresses

Primary practice location

140 Kings Daughters Drive Suite 400
Frankfort, KY 40601

Mailing address

140 Kings Daughters Drive Suite 400
Frankfort, KY 40601
Phone (502) 699-2885

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL panaceahealthcarellc@gmail.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250731002119 KY Part B Supplier - Clinic/Group Practice 3678081841 Receives reassigned benefits from 1 practitioner
Practice locations: Frankfort, KY

National Provider Directory

National Provider Directory

Locations

140 Kings Daughters Dr
Ste 400
Frankfort, KY 40601
Phone (502) 219-2603

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1700541646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 KINGS DAUGHTERS DRIVE SUITE 400",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "40601",
            "telephone_number": "502-699-2885",
            "fax_number": "502-699-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 KINGS DAUGHTERS DRIVE SUITE 400",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "40601",
            "telephone_number": "502-699-2885",
            "fax_number": "502-699-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-229-4017",
        "authorized_official_credential": "LADC, CADC, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "panaceahealthcarellc@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "140 Kings Daughters Dr Ste 400",
            "city": "Frankfort",
            "state": "KY",
            "country_code": "US",
            "postal_code": "406014242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.