NPIMap

Organization Active NPI

Bardwell Wellness Center LLC

  • Family Medicine Physician
  • Bardwell, KY
National Provider Identifier
1851970602
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BARDWELL WELLNESS CENTER LLC
Practice address
178 US Highway 51 N Ste B
Bardwell, KY 42023-9096
Phone
(270) 628-5445
Fax
(270) 628-3179
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Chris AugustusNPI 1083994784
Title
Authorized Official
Phone
(270) 628-5445

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

178 US Highway 51 N Ste B
Bardwell, KY 42023-9096

Mailing address

178 US Highway 51 N Ste B
Bardwell, KY 42023-9096
Phone (270) 628-5445

Other names 1

  • Bardwell Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

178 US Highway 51 N
Ste B
Bardwell, KY 42023
Phone (270) 628-5445

Practitioners & affiliated clinicians

Practitioners 2

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": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1851970602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 US HIGHWAY 51 N STE B",
            "city": "BARDWELL",
            "state": "KY",
            "postal_code": "420239096",
            "telephone_number": "270-628-5445",
            "fax_number": "270-628-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 US HIGHWAY 51 N STE B",
            "city": "BARDWELL",
            "state": "KY",
            "postal_code": "420239096",
            "telephone_number": "270-628-5445",
            "fax_number": "270-628-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARDWELL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "AUGUSTUS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "270-628-5445"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bardwell Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bardwell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.