WILD HEALTH, INC. (NPI# 1174133441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174133441 |
| Entity Type | Organization |
| Organization Name | WILD HEALTH, INC. |
| Practice Address |
535 Wellington Way Ste 330 Lexington KY 40503-1331 |
| Practice Telephone | 8594390400 |
| Practice Fax Number | 8594390399 |
| Mailing Telephone | 8594390400 |
| Mailing Fax Number | 8594390399 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | RYAN MILLER (VP OF CLINICAL OF OPERATIONS) |
| Authorized Official Telephone | 8594390400 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QG0250X |
Clinic/Center Specialization: Genetics |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
535 WELLINGTON WAY STE 330 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40503-1331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922386804 | Phillip Andrew Williford | Physician Assistant | 535 Wellington Way Ste 330, Lexington, KY 40503-1331 | 2011-07-27 |
| 1700408671 | Jean Nicole Perkins | Nurse Practitioner | 535 Wellington Way Ste 330, Lexington, KY 40503-1331 | 2020-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804743 | Lucas Kyle Brothers | Occupational Therapist | 401 Lewis Hargett Cir #120, Lexington, KY 40503 | 2019-10-30 |
| 1598322364 | Bobbi Jo Macqueston | Developmental Therapist | 825 Apache Trail, Lexington, KY 40503 | 2019-05-28 |
| 1750846234 | Smart Dental & Hygiene Express | Dentist | 2600 Nicholasville Rd Suite 120, Lexington, KY 40503 | 2019-02-08 |
| 1780148353 | Southland Child, Adult, and Family Counseling | Counselor | 2039 Regency Rd., Ste 1, Lexington, KY 40503 | 2019-01-28 |
| 1073093357 | Amanda Zachem | Nurse Practitioner | 1780 Nicholasville Rd., Suite #203, Lexington, KY 40503 | 2018-08-16 |
| 1083101240 | Man O War Urgent Care LLC | Nurse Practitioner | 4097 Nichols Park Dr Ste 108, Lexington, KY 40503 | 2018-04-13 |
| 1255833737 | Bennett Gatto | Physical Therapist | 3882 Mall Road, Lexington, KY 40503 | 2018-03-01 |
| 1528566114 | Alteri, LLC | Counselor | 1517 Nicholasville Rd Ste 402, Lexington, KY 40503 | 2018-01-29 |
| 1245748235 | Sherry Kay Adkins | Registered Nurse | Baptist Health Lexington 1740 Nicholasville Road, Diabetes Education, Lexington, KY 40503 | 2018-01-12 |
| 1003334780 | Martin Bennett Hundley | Counselor | 274 Southland Dr # 204, Lexington, KY 40503 | 2017-09-01 |
| Find all providers in zip 40503 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1467908095 | Careatc - Leggett & Platt - Lexington, Nc | Clinic/Center | 3040 Junior Order Home Road, Lexington, NC 27292 | 2016-09-01 |
| 1518217389 | Wade D Reynolds Do, LLC | Clinic/Center | 111 Ivy Park Ln, Suite C, Lexington, SC 29072-8289 | 2012-09-19 |
| 1023266509 | Family First Medical Clinic | Clinic/Center | 21 W Church St, Lexington, TN 38351-2009 | 2008-09-08 |
| 1013905710 | Transsouth Healthcare PC | Clinic/Center | 120 E Church St, Lexington, TN 38351-1821 | 2005-10-07 |
| 1104459502 | Chevy Chase Primary Care LLC | Clinic/Center | 330 Romany Rd, Lexington, KY 40502-2404 | 2020-02-14 |
| 1538527254 | Viphealth LLC | Clinic/Center | 117 Park Place Ct, Lexington, SC 29072-6690 | 2016-02-09 |
| Find all providers in LEXINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.