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1497007090

NPI Code Detail

MEDICARE: NEW VISTA OF THE BLUEGRASS INC

MEDICARE: NEW VISTA OF THE BLUEGRASS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20354400	OTHER	KY	MAGELLAN
2	207023	OTHER	KY	MHN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	242395	OTHER	KY	COMPSYCH
5	874068	OTHER	KY	USA
6	000000057414	OTHER	KY	ATHEM
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	101483	OTHER	KY	CHA INSURANCE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	091018	OTHER	KY	VALUE OPTIONS

General Provider Information

NPI Number	:	1497007090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VISTA OF THE BLUEGRASS INC

Provider Business Mailing Address
First Line	:	1351 NEWTOWN PIKE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1275
Country	:	US
Telephone Number	:	859-253-1686
Fax Number	:

Provider Business Practice Location Address
First Line	:	3479 BUCKHORN DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-1114
Country	:	US
Telephone Number	:	859-253-1686
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. DEE WERLINE
Credential	:
Telephone Number	:	859-253-1686

Provider Enumeration Date	:	10/05/2012
Last Update Date	:	10/12/2020

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1023461050 — PROF. REBECCA SUE KATZ PEER SUPPORT SPECIAL
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1972046183 — SIERRA JOHNSON
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1093258279 — ANITA LOUISE BROOMALL RN
Practice Location Address:

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Practice Fax: 859-273-2184

1326575259 — MS. BRENDA ANN HOLDER
Practice Location Address:

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Practice Fax:

1174091300 — ANDREA RACHELLE WEBB
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Directions to “NEW VISTA OF THE BLUEGRASS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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