RADIANT PRIME
NPI 1700602364
Family Medicine - Addiction Medicine in Mount Sterling, KY
- Organization
- Family Medicine
- Addiction Medicine
- CLIA Number: 18D2325370
- CLIA Cert. Type: Other - TREATMENT PRACTITIONER
- CLIA Exp. Date: 06-10-2027
About RADIANT PRIME
This page provides the complete NPI Profile along with additional information for Radiant Prime, a provider established in Mount Sterling, Kentucky operating as a Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1700602364 assigned on November 2024. The practitioner's primary taxonomy code is 207QA0401X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Jessica Nicole Mcglone Aprn (Owner & Ceo)
- NPI
- 1700602364 Verify this NPI
- Provider Name
- RADIANT PRIME
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 7075 WADES MILL RD MOUNT STERLING, KY 40353
- Location Phone
- (813) 384-8050
- Location Fax
- (813) 336-8804
- Mailing Address
- 4948 REFLECTING POND CIR WIMAUMA, FL 33598
- Mailing Phone
- (813) 384-8050
- Mailing Fax
- (813) 336-8804
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-28-2024
- Last Update Date
- 04-24-2025
- Code Navigator
Location Map
Secondary Locations
- 4948 Reflecting Pond Cir
Wimauma, FL 33598
(813) 384-8050
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Addiction Medicine
- Taxonomy Code
- 207QA0401X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician who specializes in the diagnosis and treatment of addictions.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 18D2325370
- Facility Type
- Other - TREATMENT PRACTITIONER
- Certificate Effective Date
- June 11, 2025
- Certificate Expiration Date
- June 10, 2027
- Laboratory Director
- MS. JESSICA N. MCGLONE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Radiant Prime to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700602364, enumerated as an "organization" on November 28, 2024.
The provider is located at 7075 WADES MILL RD MOUNT STERLING, KY 40353 and the phone number is (813) 384-8050.
Family Medicine with taxonomy code 207QA0401X and a focus in Addiction Medicine.
