Albaree Health Services LLC
Organization Active NPI Internal Medicine Physician · Salyersville, KY
NPI 1730232182 · NPPES record last updated Jan 2, 2024
Key facts
- NPI
- 1730232182
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ALBAREE HEALTH SERVICES LLC
- Practice address
- 900 Tom Frazier Way, Ste 200
Salyersville, KY 41465-8123 - Phone
- (606) 349-8100
- Fax
- (606) 349-8150
- NPI assigned
- Jan 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Antoin Hana, MD
- Title
- Owner
- Phone
- (606) 349-8100
Owners & managing parties with NPI records 1
-
Antoin Hana, M.D.
Practitioners 45
-
Vikki Bonyata, MA/M.ED/CADC/LPCC
-
Blake R Burchett, MD
-
Robin R. Goble, LCSW
-
Terri Lynn Hall, APRN
-
Amanda Marie Helton, APRN
-
Susie Michelle Howard, APRN
-
Trevor Howard, PMHNP-BC
-
Mary Music, APRN
-
Carlee Jlynn Salisbury, APRN, FNP-C
-
Mary Elizabeth Setser, ARNP
-
Melissa Gay Slone, LPCC
-
Kelly Elizabeth Howard, PA-C
-
Rhonda Nickie Meadows, PA C
-
Ashley Conley, APRN
-
Kayla Conn, PMHNP-BC
-
Helen Renee Doan, LPCC-S
-
Samantha Lee Fraley, APRN,MSN,FNP-C
-
Sarah Elizabeth Hall, APRN
-
Antoin Hana, M.D.
-
Lorna Isaac, ARNP
-
Gerri Martin, APRN, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D1043255 | Albaree Health Services LLC | Compliance | Sep 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Rural health clinic certification: CCN 183941
- Legal name
- ALBAREE HEALTH SERVICES LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 20, 2005
- Last certification
- Jul 24, 2019
- Ownership / control type
- 1B
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 6, 2005 in KY
- Enrollment address
- 900 Tom Frazier Way
Ste 200
Salyersville, KY 41465-7686
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Antoin Hana |
5% Or Greater Direct Ownership Interest | Aug 26, 2014 | 100% |
| W-2 Managing Employee |
Aug 26, 2014 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050816000475 | KY | Part B Supplier - Clinic/Group Practice | 5991735391 |
Receives reassigned benefits from 39 practitioners Practice locations: Salyersville, KY |
| O20051118000484 | KY | Part a Provider - Rural Health Clinic | 5991735391 | Practice locations: Salyersville, KY |
National Provider Directory
Locations
906E MTN Pkwy
Salyersville, KY 41465
Phone (606) 349-8100
186 Brenna Blvd
Ste 500
Salyersville, KY 41465
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | |||
| Family Medicine Physician |
207Q00000X | |||
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Rural Health Clinic/Center | 261QR1300X | 900192 | KY | |
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
900 Tom Frazier Way, Ste 200
Salyersville, KY 41465-8123
Mailing address
PO Box 280
Prestonsburg, KY 41653-0280
Phone (606) 349-8100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35001957 | Medicaid | KY |
Other providers in Salyersville, KY
- Judith Starr Adams
- Albaree Health Services, LLC
- Baher Alhomsi
- Appalachian Regional Healthcare, Inc
- Appalachian Rehabilitation Team, Inc
- Arh Tug Valley Health Services, Inc.
All providers in Salyersville, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.