Breathitt County Health Department

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

BREATHITT COUNTY HEALTH DEPARTMENT

Practice address

955 Hwy. 30 West
Jackson, KY 41339-1000

Phone

(606) 666-7755

Fax

(606) 666-4601

NPI assigned

Jan 23, 2007

Last updated

Jul 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Angela M Raleigh, MS,RD,LD

Title

Director

Phone

(606) 666-7755

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Breathitt County Health Department

  dba Breathitt County Home Health

  • Home Health Agency
  • Jackson, KY
  • NPI 1295809291

  4880657956

  Same PAC ID

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

CLIA laboratory certificates

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Breathitt County Health Department

  dba Breathitt County Home Health

  • Home Health Agency
  • Jackson, KY
  • NPI 1295809291

  5% Or Greater Indirect Ownership Interest, Operational/Managerial Control

  CMS ownership

Practitioners 3

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.

• Eunice Louise Johnson, MD

  • Gynecology Physician
  • Jackson, KY
  • NPI 1528067840
  NPD (past)
• Chandramohan P Batra, MD

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1720034796
  NPD (past)
• Stephan N Trent, DO

  • Family Medicine Physician
  • Casper, WY
  • NPI 1972546851
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1770637969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413390730",
            "telephone_number": "606-666-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 HWY. 30 WEST",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413391000",
            "telephone_number": "606-666-7755",
            "fax_number": "606-666-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATHITT COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "RALEIGH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "606-666-7755",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS,RD,LD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20013017",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15001068",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Shawn Bradley, PHARMD
• Breathit County Imaging Center
• Breathitt County Ambulance, Inc.
• Breathitt County Board of Education
• Breathitt County Health Department (Breathitt County Home Health)
• Breathitt County Home Medical LLC
• Breathitt Dental Clinic PSC
• Breathitt Emergency Group, LLC
• Breathitt-Wolfe EMS Inc
• Breatitt County Geriatric Corporation (nim henson geriatric center)

• Public Health or Welfare Agency in Jackson, KY
• Providers in Jackson, KY by specialty
• Public Health or Welfare Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.