Organization Active NPI

Mill Pond Integrative Health and Wellness Center

  • Physical Medicine & Rehabilitation Physician
  • Lexington, KY
National Provider Identifier
1811442007
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MILL POND INTEGRATIVE HEALTH AND WELLNESS CENTER
Practice address
3650 Boston Rd
Suite 188
Lexington, KY 40514-1569
Phone
(859) 219-0617
Fax
(859) 219-0622
NPI assigned
Aug 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
Justin PearceNPI 1265700215
Title
Clinic Director
Phone
(859) 219-0617

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
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

3650 Boston Rd
Suite 188
Lexington, KY 40514-1569

Mailing address

3650 Boston Rd
Suite 188
Lexington, KY 40514-1569
Phone (859) 219-0617

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1811442007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 BOSTON RD",
            "address_2": "SUITE 188",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405141569",
            "telephone_number": "859-219-0617",
            "fax_number": "859-219-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 BOSTON RD",
            "address_2": "SUITE 188",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405141569",
            "telephone_number": "859-219-0617",
            "fax_number": "859-219-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL POND INTEGRATIVE HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "PEARCE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "859-219-0617"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.