=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942096144
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADOM WELLNESS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2025
-----------------------------------------------------
Last Update Date | 12/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4150 ALEXANDRIA PIKE STE 111
-----------------------------------------------------
City | COLD SPRING
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41076-3529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-304-0307
-----------------------------------------------------
Fax | 855-393-8538
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4150 ALEXANDRIA PIKE STE 111
-----------------------------------------------------
City | COLD SPRING
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41076-3529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-304-0307
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CHARLOTTE SAVILL
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 513-304-0307
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------