Kentucky Addiction Centers Paducah LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KENTUCKY ADDICTION CENTERS PADUCAH LLC

Practice address

148 Stuart Nelson Park Rd
Paducah, KY 42001-9678

Phone

(270) 908-2681

NPI assigned

Dec 15, 2020

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": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1962098822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 STUART NELSON PARK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 STUART NELSON PARK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019678",
            "telephone_number": "270-908-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY ADDICTION CENTERS PADUCAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "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": []
}

• Natasha Jean Kendrick
• Lauren Kennady, PHARMD
• Jennifer Michelle Kennedy, APRN
• Kenneth G Cook MD PSC
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• Kentucky Addiction Centers West 2, LLC
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• Kentucky CVS Pharmacy, L.L.C.
• Kentucky CVS Pharmacy, L.L.C.
• Kentucky CVS Pharmacy, L.L.C.

• Family Medicine Physician in Paducah, KY
• Providers in Paducah, 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 Dec 15, 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.