1025 Health, LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

1025 HEALTH, LLC

Practice address

110 Hardin LN
Somerset, KY 42503-3818

Phone

(606) 451-9748

NPI assigned

Jul 21, 2020

Organization subpart

Yes

Parent organization

1104270As reported in NPPES

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

Authorized official

Name

Mr. Robert Johnson, APRNNPI 1417467010

Title

NP

Phone

(606) 451-9748

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

1025 Health LLC

Locations

Practitioners 1

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

• Robert Johnson, NP

  • Adult Health Nurse Practitioner
  • Somerset, KY
  • NPI 1417467010
  NPD Authorized official

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1891303368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-451-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1025 HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1104270",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "606-451-9748",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417467010",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A New Beginning Achievement Center
• Abrahim Abdollahi, CSFA
• Abenia LLC
• Shekwonugaza Aboki, DPM
• Acemark Behavior Services LLC

• Adult Health Nurse Practitioner in Somerset, KY
• Providers in Somerset, KY by specialty
• Adult Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.