2ND CHANCE NPI 1215348214

NPI Information

  • NPI: 1215348214
  • Provider Name: 2ND CHANCE
  • Classification: Internal Medicine - 207RA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • CLIA Number: 18D2212741
  • Address: 1420 N BROADWAY
    LEXINGTON, KY
    ZIP 40505
  • Phone: (859) 368-9874

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NPI Details

2ND CHANCE is an addiction medicine internal medicine in Lexington, KY. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. 2ND CHANCE NPI is 1215348214. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1420 N BROADWAY
LEXINGTON, KY
ZIP 40505-155
Phone: (859) 368-9874
Fax: (859) 368-8822

The provider's authorized official is Deborah Farmer .
The authorized official title is Mgr and has the following contact phone number (859) 368-8820.

The CLIA number assigned to this NPI record is 18D2212741 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/13/2014 and was last updated on 5/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0401XInternal MedicineAddiction MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100338550MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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