| Fresh Start Health Psc | |
|
336 29th St Ste 203 Ashland KY 41101-1932 | |
| (606) 225-8200 | |
| (888) 606-7354 |
| Full Name | Fresh Start Health Psc |
|---|---|
| Speciality | Neurological Surgery |
| Location | 336 29th St Ste 203, Ashland, Kentucky |
| Authorized Official Name and Position | Jerrel Boyer (OWNER) |
| Authorized Official Contact | 6062258200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Health Psc 336 29th St Ste 203 Ashland KY 41101-1932 Ph: (606) 225-8200 | Fresh Start Health Psc 336 29th St Ste 203 Ashland KY 41101-1932 Ph: (606) 225-8200 |
| NPI Number | 1487143806 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 01/31/2022 |
| Certification Date | 01/27/2022 |
| Medicare PECOS PAC ID | 6204184997 |
|---|---|
| Medicare Enrollment ID | O20180813003091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487143806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 207T00000X | Neurological Surgery | (* (Not Available)) | Primary |
| Provider Name | Jon H Walz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871544817 PECOS PAC ID: 1658383328 Enrollment ID: I20060620000263 |
| Provider Name | Jerrel Boyer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083785075 PECOS PAC ID: 5092704262 Enrollment ID: I20070724000413 |
| Provider Name | Bethel A Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841692555 PECOS PAC ID: 9537481429 Enrollment ID: I20141203002268 |
| Provider Name | Freda Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639611007 PECOS PAC ID: 4284916313 Enrollment ID: I20170330000429 |
| Provider Name | Lori Ann Ervin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255841797 PECOS PAC ID: 3274892690 Enrollment ID: I20180410000711 |
| Provider Name | Vanessa Flannery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396238218 PECOS PAC ID: 4688085053 Enrollment ID: I20201117000411 |
| Provider Name | Maryellen Tussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063026110 PECOS PAC ID: 7113335035 Enrollment ID: I20210414000972 |
| Provider Name | Ashlee Shae Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588262059 PECOS PAC ID: 8426457011 Enrollment ID: I20210602001603 |
| Provider Name | Carrie Walker Norden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942908330 PECOS PAC ID: 5496128597 Enrollment ID: I20230309002330 |
| Provider Name | Brittni Leigh Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215632559 PECOS PAC ID: 3375906605 Enrollment ID: I20230901002977 |
| Provider Name | Jennah Paige Baier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851864805 PECOS PAC ID: 7416480694 Enrollment ID: I20241025002850 |
| Provider Name | Flash Phipps |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083772800 PECOS PAC ID: 6103352588 Enrollment ID: I20241209002380 |
| Provider Name | Candy A Colyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376095943 PECOS PAC ID: 9638608458 Enrollment ID: I20250123002736 |
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