KENTUCKIANA SURGICAL SPECIALISTS PSC (NPI# 1033140579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033140579 |
| Entity Type | Organization |
| Organization Name | KENTUCKIANA SURGICAL SPECIALISTS PSC |
| Practice Address |
3900 Kresge Way 44 Louisville KY 40207-4660 |
| Mailing Address |
3900 Kresge Way Suite 44 Louisville KY 40207-4660 |
| Practice Telephone | 5028976700 |
| Practice Fax Number | 5028976704 |
| Mailing Telephone | 5028976700 |
| Mailing Fax Number | 5028976704 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KRISTIN M MIRACLE (OFFICE MANAGER) |
| Authorized Official Telephone | 5028976700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | KY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 1172499 | 05 | |
| KY | 65933244 | 05 |
| Street Address |
3900 KRESGE WAY 44 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225032014 | Anthony George Jr. | Specialist | 3900 Kresge Way, Suite 31, Louisville, KY 40207-4660 | 2005-06-09 |
| 1821649849 | Amanda Hellmueller | Nurse Practitioner | 3900 Kresge Way, Louisville, KY 40207-4660 | 2019-09-20 |
| 1063948677 | Lyndsay P Delaney | Nurse Practitioner | 3900 Kresge Way, Suite 46, Louisville, KY 40207-4660 | 2017-05-03 |
| 1902343957 | Susette R Roark | Nurse Practitioner | 3900 Kresge Way, Ste 46, Louisville, KY 40207-4660 | 2017-01-30 |
| 1194198077 | Emily Dubois Hollander | Midwife | 3900 Kresge Way, Suite 30, Louisville, KY 40207-4660 | 2015-11-02 |
| 1932503919 | Rose Ballard | Nurse Practitioner | 3900 Kresge Way, Suite 56, Louisville, KY 40207-4660 | 2014-10-20 |
| 1508104258 | Tabitha Satterly-welborn | Nurse Practitioner | 3900 Kresge Way, Suite 46, Louisville, KY 40207-4660 | 2013-01-30 |
| 1023361003 | Kristen Rae Hord | Physician Assistant | 3900 Kresge Way, Ste 30, Louisville, KY 40207-4660 | 2012-10-16 |
| 1710238001 | Kaitlin Sullivan | Physician Assistant | 3900 Kresge Way, Suite 30, Louisville, KY 40207-4660 | 2012-09-26 |
| 1538415070 | Diana Blevins | Nurse Practitioner | 3900 Kresge Way, Ste.46, Louisville, KY 40207-4660 | 2012-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674797 | Sarah Cb Tucker | Specialist | 1169 Eastern Pkwy, Suite 2313, Louisville, KY 40217-1417 | 2020-03-18 |
| 1104457795 | David B. Beltz | Specialist | 6911 Ravenna Ave Ne, Louisville, OH 44641-4464 | 2020-01-31 |
| 1306480967 | Shawnas Monique Moore | Specialist | 3007 Dr William G Weathers Dr, Louisville, KY 40211-1891 | 2019-11-06 |
| 1083124366 | Kentuckiana Pain Specialist Ambulatory Surgery Center | Specialist | 3710 Chamberlain Ln Ste B, Louisville, KY 40241-2002 | 2017-10-02 |
| 1902345994 | Hps Kentucky LLC | Specialist | 444 Sourth First Street, Louisville, KY 40202 | 2017-02-23 |
| 1134578032 | Fernando Pajo Jr. | Specialist | 5007 Old Federal Rd, Louisville, KY 40207-1200 | 2016-06-10 |
| 1144616749 | James David Dorneman Jr. | Specialist | 4346 Bowling Blvd, Louisville, KY 40207-5405 | 2015-04-09 |
| 1609269414 | Preston Medical Center | Specialist | 927 S 3rd St, Louisville, KY 40203-2215 | 2015-03-18 |
| 1821437468 | Cordelia Marie Devine | Specialist | 1100 Envoy Cir, Suite 1105, Louisville, KY 40299-1960 | 2013-06-17 |
| 1154765550 | Therapy Associates of Louisville, LLC | Specialist | 4810 Poplar Place Dr Ste 100, Louisville, KY 40213-2383 | 2013-04-29 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
Please comment or provide details below to improve the information on KENTUCKIANA SURGICAL SPECIALISTS PSC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.