Restoration House Ministries

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

RESTORATION HOUSE MINISTRIES

Practice address

980 W Highway 25 70
Newport, TN 37821-9006

Phone

(865) 805-0567

NPI assigned

Apr 10, 2023

Last updated

Feb 28, 2024By 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

Matthew Johnson, M.A., M.DIVNPI 1467179929

Title

Director/Manager

Phone

(865) 805-0567

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821783374. Details of each certification follow.

• CCN 444547 Comprehensive outpatient rehabilitation facility · Active · Name & address match · Details

Comprehensive outpatient rehabilitation facility certification: CCN 444547

Legal name

RESTORATION HOUSE MINISTRIES

Certification status

Active

Provider type (POS)

Comprehensive outpatient rehabilitation facility

Participating since

Jun 23, 2023

Last certification

Jun 23, 2023

Ownership / control type

Other

Facility address

980 W Highway 25 70
Newport, TN 37821

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.

• Matthew Johnson, M.A., M.DIV

  • Addiction (Substance Use Disorder) Counselor
  • Kodak, TN
  • NPI 1467179929
  NPD (past) Authorized official
• Micah Bonner, MA, LADAC-II

  • Addiction (Substance Use Disorder) Counselor
  • Newport, TN
  • NPI 1639052251
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1821783374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 WINFIELD DUNN PKWY",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377642100",
            "telephone_number": "865-805-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W HIGHWAY 25 70",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378219006",
            "telephone_number": "865-805-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HOUSE MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR/MANAGER",
        "authorized_official_telephone_number": "865-805-0567",
        "authorized_official_credential": "M.A., M.DIV"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexus Jayed Rhea, LPN
• Rochelly Rivera Matos
• Travis Blake Robbins, PHARMD
• Christopher Daniels Robertson, LCSW

• Substance Abuse Rehabilitation Facility in Newport, TN
• Providers in Newport, TN by specialty
• Substance Abuse Rehabilitation Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.