Autumn Victoria Justice, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

05621 Issued in KY

Practice address

305 Langdon St
Somerset, KY 42503-2750

Phone

(606) 679-7441

NPI assigned

Apr 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

West Virginia School of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apogee Medical Group Kentucky PSCGroup PAC ID 8820164411, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132
• Russell County Hospital Hospital, Russell Springs, KY, CCN 181330
• Wayne County Hospital Hospital, Monticello, KY, CCN 181321
• Lake Cumberland Regional Hospital Scu Nursing home, Somerset, KY, CCN 185407

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Apogee Medical Group Kentucky PSC

  • General Practice Physician
  • Corbin, KY
  • NPI 1356503114
  Medicare reassignment Care Compare group NPD
• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Lake Cumberland Regional Hospital LLC

  • Skilled Nursing Facility
  • Somerset, KY
  • NPI 1629130562

  Nursing home

  Care Compare affiliation
• Russell County Hospital

  • Critical Access Hospital
  • Russell Springs, KY
  • NPI 1013954437
  Care Compare affiliation
• Wayne County Hospital, Inc

  • Critical Access Hospital
  • Monticello, KY
  • NPI 1871548016
  Care Compare affiliation

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1841872801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 C MCKINLEY RD",
            "city": "JAMESTOWN",
            "state": "KY",
            "postal_code": "42629",
            "telephone_number": "270-566-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-679-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "AUTUMN",
        "middle_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Jordan, OTR/L
• Joseph S.Petrey PLLC
• Julie Joseph-Fox, M.A.
• Dennis Jose Joseph
• Breanna G Judd
• Benjamin Thomas Kabel, CRNA
• Kaleidoscope Insights
• Aslin Leshae Kane, LSW
• Kasey R Compton & Associates, PLLC
• Olivia Kates, RD

• Internal Medicine Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.