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JUNIPER HEALTH INC NPI 1467417691


NPI Information

NPI: 1467417691
Provider Name: JUNIPER HEALTH INC

Doing Business As: BREATHITT COUNTY FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 18D0975290

Address:
1484 LAKESIDE DRIVE
JACKSON, KY
ZIP 41339
Phone: (606) 666-9950
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JUNIPER HEALTH INC is a federally qualified health center (fqhc) clinic center in Jackson, KY. JUNIPER HEALTH INC NPI is 1467417691. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Breathitt County Family Health Center.

The provider's business location address is:

1484 LAKESIDE DRIVE
JACKSON, KY
ZIP 41339-370
Phone: (606) 666-9950
Fax: (606) 666-9136

The provider's authorized official is Derrick J Hamilton .
The authorized official title is Ceo and has the following contact phone number (606) 666-9950.

The CLIA number assigned to this NPI record is 18D0975290 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 7/14/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)700140KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
131000854MEDICAIDKENTUCKY
2181853OTHERKENTUCKYMEDICARE FQHC PTAN
39521OTHERKENTUCKYMEDICARE PART B

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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