NPIMap

Organization Active NPI

Albaree Health Services LLC

  • Internal Medicine Physician
  • Salyersville, KY
National Provider Identifier
1730232182
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 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
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Dr. Antoin Hana, MDNPI 1669483830
Title
Owner
Phone
(606) 349-8100

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Rural Health Clinic/Center 261QR1300X 900192 KY
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730232182. Details of each certification follow.

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
LLCProprietary
Incorporated
Apr 6, 2005 in KY
Enrollment address
900 Tom Frazier Way
Ste 200
Salyersville, KY 41465-7686

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
18D1043255Albaree Health Services LLC900 Tom Frazier Way, Ste 500, Salyersville, KY 41465ComplianceSep 21, 2027

National Provider Directory

National Provider Directory

Locations

186 Brenna Blvd
Ste 500
Salyersville, KY 41465
Phone (606) 349-8400

900 Tom Frazier Way
#200
Salyersville, KY 41465
Phone (606) 349-8100

906E MTN Pkwy
Salyersville, KY 41465
Phone (606) 349-8100

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Antoin Hana Individual 5% Or Greater Direct Ownership Interest Aug 26, 2014 100%
W-2 Managing EmployeeCeo Aug 26, 2014 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1730232182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530280",
            "telephone_number": "606-349-8100",
            "fax_number": "606-349-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOM FRAZIER WAY, STE 200",
            "city": "SALYERSVILLE",
            "state": "KY",
            "postal_code": "414658123",
            "telephone_number": "606-349-8100",
            "fax_number": "606-349-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBAREE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-01-02",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "HANA",
        "authorized_official_first_name": "ANTOIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-349-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900192",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salyersville, KY

Sources for this page

Verify at the official NPI Registry.