Organization · NPI-2
A New Start Primary Care LLC
Clinic/Center, Primary Care · Henderson, KY
NPI number1629784418
StatusActive
Last updated in NPPESFeb 1, 2024
Details
- NPI
- 1629784418
- Entity type
- Organization (NPI-2)
- Legal business name
- A New Start Primary Care LLC
- Organization subpart
- No
- Enumeration date
- Jan 25, 2023
- Certification date
- Feb 1, 2024
- Last updated
- Feb 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 101YP2500X | Counselor, Professional | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207QA0401X | Family Medicine, Addiction Medicine | – | – | |
| 207RA0401X | Internal Medicine, Addiction Medicine | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
114 Franklin StHenderson, KY 42420-3342
Phone 866-934-4611 · Fax 270-754-3499
Mailing address
114 Franklin StHenderson, KY 42420-3342
Phone 866-934-4611 · Fax 270-754-3499
Other practice locations
1704 2nd St
Henderson, KY 42420-3366
Henderson, KY 42420-3366
Phone 270-757-2202 · Fax 270-757-2378
Authorized official
Timothy R Dukes
Ceo & President
2707543494
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