| A New Start Ii, Llc | |
|
222 Phillip Stone Way Central City KY 42330 | |
| (866) 934-4611 | |
| (270) 754-3499 |
| Full Name | A New Start Ii, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 Phillip Stone Way, Central City, Kentucky |
| Authorized Official Name and Position | William Kelly Vincent (ADMINISTRATOR) |
| Authorized Official Contact | 2707543494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A New Start Ii, Llc 222 Phillip Stone Way Central City KY 42330-1929 Ph: (866) 934-4611 | A New Start Ii, Llc 222 Phillip Stone Way Central City KY 42330 Ph: (866) 934-4611 |
| NPI Number | 1467823328 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Medicare PECOS PAC ID | 6204170848 |
|---|---|
| Medicare Enrollment ID | O20181207001632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467823328 | NPI | - | NPPES |
| Provider Name | Tariq K Malik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659434728 PECOS PAC ID: 8022915651 Enrollment ID: I20031212000710 |
| Provider Name | William K Vincent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801897855 PECOS PAC ID: 7517911985 Enrollment ID: I20060222000203 |
| Provider Name | Barry G Hardison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225039258 PECOS PAC ID: 4880697713 Enrollment ID: I20081108000052 |
| Provider Name | Donna J Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982872206 PECOS PAC ID: 6901940113 Enrollment ID: I20100225000184 |
| Provider Name | Denise H Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801897830 PECOS PAC ID: 7113052531 Enrollment ID: I20100324000041 |
| Provider Name | James P Brook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578990776 PECOS PAC ID: 8820316649 Enrollment ID: I20150407001801 |
| Provider Name | Courtney S Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083764914 PECOS PAC ID: 5890002661 Enrollment ID: I20150911001321 |
| Provider Name | Jolynn Gaither-wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588021877 PECOS PAC ID: 9133423502 Enrollment ID: I20160204001148 |
| Provider Name | Carson Teague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679933626 PECOS PAC ID: 0143527960 Enrollment ID: I20160322002425 |
| Provider Name | Echo Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871016287 PECOS PAC ID: 6800167743 Enrollment ID: I20170810001594 |
| Provider Name | Kathy L Tichenor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447635818 PECOS PAC ID: 7315219722 Enrollment ID: I20170821000289 |
| Provider Name | Lori Humphries |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922423763 PECOS PAC ID: 2668719675 Enrollment ID: I20190129003785 |
| Provider Name | Holly Annette Groves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962618033 PECOS PAC ID: 8527348242 Enrollment ID: I20190903002082 |
| Provider Name | Dorothy Danielle-maria Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760979413 PECOS PAC ID: 6406109222 Enrollment ID: I20191214000247 |
| Provider Name | Melinda Kay Nightingale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255961827 PECOS PAC ID: 8921435348 Enrollment ID: I20200225001593 |
| Provider Name | Donna A Woodward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215010491 PECOS PAC ID: 0244640266 Enrollment ID: I20201103001847 |
| Provider Name | Debra L Hardison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851922744 PECOS PAC ID: 8426460239 Enrollment ID: I20201221001543 |
| Provider Name | Mary Elizabeth Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144826298 PECOS PAC ID: 6709290406 Enrollment ID: I20210120001636 |
| Provider Name | Amanda S. Cecil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467906123 PECOS PAC ID: 4789091505 Enrollment ID: I20210323002456 |
| Provider Name | Rachel M Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184201667 PECOS PAC ID: 3779991153 Enrollment ID: I20210423001400 |
| Provider Name | Tabatha L Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134766603 PECOS PAC ID: 2668867391 Enrollment ID: I20220316001870 |
| Provider Name | Raven C Steele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922506880 PECOS PAC ID: 6406239177 Enrollment ID: I20220812000317 |
| Provider Name | Chaslyn Eve-anmarie Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932828555 PECOS PAC ID: 0042665325 Enrollment ID: I20231005002118 |
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