UNBRIDLED HEALTHCARE SYSTEM LLC
NPI 1295461663
General Practice in London, KY
About Unbridled Healthcare System Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UNBRIDLED HEALTHCARE SYSTEM LLC (NPI 1295461663) is a healthcare organization registered as a general practice in London, Kentucky and active in the NPI registry since July 2022. The organization holds a CLIA Waiver certificate valid through November 2, 2027 and lists Terri Tye, Billing And Credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Unbridled Healthcare System Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Unbridled Healthcare System LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 18D2293184
Unbridled Healthcare · London, KYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Unbridled Healthcare System LLC's NPI number?
The NPI number for Unbridled Healthcare System LLC is 1295461663. It was assigned to this organization in the NPPES registry on July 28, 2022.
Where is Unbridled Healthcare System LLC located?
Unbridled Healthcare System LLC is located at 220 N Main St, London, KY 40741. The listed phone number is (606) 770-3014.
What is Unbridled Healthcare System LLC's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Unbridled Healthcare System LLC enrolled in Medicare?
Yes. Unbridled Healthcare System LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Unbridled Healthcare System LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Unbridled Healthcare System LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Clinical Social Worker (1) and General Practice (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Unbridled Healthcare System LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D2293184) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Unbridled Healthcare System LLC was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Unbridled Healthcare System Llc · NPI 1295461663
General Practice organization in London, Kentucky. Organization record, active in the CMS NPPES registry since July 28, 2022.
## Identity
- **NPI:** 1295461663 (Entity type: Organization)
- **Enumerated:** July 28, 2022
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Terri Tye, BILLING AND CREDENTIALING
## Practice location
- **Address:** 220 N MAIN ST, London, KY 40741-1367
- **Phone:** (606) 770-3014
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Clinical Social Worker (1), General Practice (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 11, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295461663) · Data from the CMS NPPES public registry.