INTREPID OF SOUTHERN KENTUCKY, INC. (NPI# 1467434043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467434043 |
| Entity Type | Organization |
| Organization Name | INTREPID OF SOUTHERN KENTUCKY, INC. |
| Other Organization Name | INTREPID USA HEALTHCARE SERVICES |
| Practice Address |
230 Tower Cir Somerset KY 42503-3480 |
| Mailing Address |
3220 Keller Springs Rd Ste 108 Carrollton TX 75006-5911 |
| Practice Telephone | 6066797439 |
| Practice Fax Number | 6066787310 |
| Mailing Telephone | 2144420967 |
| Mailing Fax Number | 2144453994 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-01-30 |
| Authorized Official Name | PAUL M MCMULLEN (COO) |
| Authorized Official Telephone | 2144453750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 150031 | KY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 374U00000X | Home Health Aide | 150031 | KY | Nursing Service Related Providers |
| Y | 251E00000X | Home Health | 150031 | KY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 34000182 | 05 | |
| KY | 42000117 | 05 | |
| KY | 45002367 | 05 |
| Other Name | Type Code |
|---|---|
| Intrepid USA Healthcare Services | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1820 Scottsville Rd Ste 203, Bowling Green, KY 421043302 | 2703923460 | |
| 220 Office Park Dr, Columbia, KY 427281381 | 2703846413 | |
| 1125 N Main St Ste 2, Monticello, KY 426332865 | 6063876954 |
| Street Address |
230 TOWER CIR |
| City | SOMERSET |
| State | KY |
| Zip Code | 42503-3480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023669652 | Carehere LLC | Family Medicine | Carehere Clinic- Toyotetsu Somerset Ky, 80 Pin Oak, Somerset, KY 42503 | 2019-09-25 |
| 1841859766 | Armina Jo Hoeck | Behavior Technician | Kid Spot Center, 200 Tower Circle, Somerset, KY 42503 | 2019-06-13 |
| 1548723042 | Lisa Hunter | Counselor | 225 Ky 2227, Somerset, KY 42503 | 2019-04-11 |
| 1982171237 | Bluegrass Hearing Clinic, LLC | Audiologist | 25 Medpark West, Suite 2, Somerset, KY 42503 | 2018-10-25 |
| 1780109116 | Kentucky Diagnostic Ultrasound, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 324 Water Cliff Dr., Somerset, KY 42503 | 2017-08-07 |
| 1689115172 | Lake Cumberland Physician Practices LLC | Internal Medicine | 154 Bogle Office Park Dr Ste B, Somerset, KY 42503 | 2017-03-16 |
| 1811356892 | Lake Cumberland Physician Practices, LLC | Nurse Practitioner | 27 Imaging Dr, Suite B, Somerset, KY 42503 | 2016-02-18 |
| 1730586447 | Amy Molen | Counselor | 259 Parkers Mill Road, Somerset, KY 42503 | 2014-11-24 |
| 1841630654 | Eastern Pulaski Rural Health Clinic,pllc | Clinic/Center | 31 Mark Shopville Rd, Somerset, KY 42503 | 2013-06-26 |
| 1881978807 | Nathan S Fisher | Counselor | 600 Clifty St Ste 2, Somerset, KY 42503 | 2011-10-10 |
| Find all providers in zip 42503 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881204766 | Alpha Umaru Bah | Home Health | 14 Meadow Hills Dr, Somerset, NJ 08873-5332 | 2020-08-05 |
| 1699392605 | Shrijicare LLC | Home Health | 3 Viking Ave, Somerset, NJ 08873-3034 | 2020-06-25 |
| 1255977989 | Nima Care Supported Living LLP. | Home Health | 781 Hamilton St, Somerset, NJ 08873-3160 | 2019-11-18 |
| 1972165611 | Evas Home Care Nj LLC | Home Health | 9 9th St, Somerset, NJ 08873-1562 | 2019-07-02 |
| 1932767498 | I&s Care, Inc. | Home Health | 5 Staudt Ct, Somerset, NJ 08873-7336 | 2019-05-30 |
| 1952863557 | Audrey A Fakondo | Home Health | 863 Hamilton St, Somerset, NJ 08873-3106 | 2019-04-02 |
| 1669822730 | Comfort Senior Care LLC | Home Health | 1820 Amwell Rd, Somerset, NJ 08873-2790 | 2016-06-20 |
| 1659744357 | Empathy Care LLC | Home Health | 1323 Highway 27, Suite E, Somerset, NJ 08873-2906 | 2015-11-04 |
| 1750723284 | Serenity Home Health of Somerset | Home Health | 132 Prewitt Place Dr, Somerset, KY 42503-5470 | 2013-07-25 |
| 1134486723 | Grace Home Health Services, Inc | Home Health | 646 Hamilton St, Somerset, NJ 08873-2632 | 2012-04-19 |
| Find all providers in SOMERSET | ||||
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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.