Kentucky Addiction Centers Paintsville, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KENTUCKY ADDICTION CENTERS PAINTSVILLE, LLC

Practice address

1032 Broadway St
Paintsville, KY 41240-1410

Phone

(606) 789-8531

NPI assigned

Mar 24, 2021

Organization subpart

No

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

Authorized official

Name

Trouper Krueger

Title

Cso-HHR

Phone

(979) 324-5456

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1922684307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 BROADWAY ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 BROADWAY ST",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401410",
            "telephone_number": "606-789-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY ADDICTION CENTERS PAINTSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "TROUPER",
        "authorized_official_title_or_position": "CSO-HHR",
        "authorized_official_telephone_number": "979-324-5456"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.