Organization Active NPI

Radiant Prime

Doing business as Radiant Prime Recovery

  • Addiction Medicine (Family Medicine) Physician
  • Mt Sterling, KY
National Provider Identifier
1700602364
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
RADIANT PRIME
Doing business as
Radiant Prime Recovery
Practice address
7075 Wades Mill Rd
Mount Sterling, KY 40353-8293
Phone
(813) 384-8050
Fax
(813) 336-8804
NPI assigned
Nov 28, 2024
Last updated
Apr 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Mrs. Jessica Nicole McGlone, APRNNPI 1891161808
Title
Owner & Ceo
Phone
(813) 384-8050

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X NU Primary

Addresses

Primary practice location

7075 Wades Mill Rd
Mount Sterling, KY 40353-8293

Mailing address

4948 Reflecting Pond Cir
Wimauma, FL 33598-4064
Phone (813) 384-8050

Other practice location 1

4948 Reflecting Pond Cir
Wimauma, FL 33598-4064
Phone (813) 384-8050

Other names 1

  • Radiant Prime Recovery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429000686 KY Part B Supplier - Clinic/Group Practice 2365968708 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Sterling, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2325370Radiant Prime Recovery7075 Wades Mill Rd, Mount Sterling, KY 40353Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1732752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1700602364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 REFLECTING POND CIR",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335984064",
            "telephone_number": "813-384-8050",
            "fax_number": "813-336-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7075 WADES MILL RD",
            "city": "MOUNT STERLING",
            "state": "KY",
            "postal_code": "403538293",
            "telephone_number": "813-384-8050",
            "fax_number": "813-336-8804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4948 Reflecting Pond Cir",
            "address_purpose": "LOCATION",
            "city": "Wimauma",
            "state": "FL",
            "postal_code": "335984064",
            "country_code": "US",
            "telephone_number": "813-384-8050",
            "fax_number": "813-336-8804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIANT PRIME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-28",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "MCGLONE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER & CEO",
        "authorized_official_telephone_number": "813-384-8050",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Prime Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radiant Prime Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.