COMMONWEALTH OF KENTUCKY (NPI# 1043298979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043298979 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | DEL MARIA |
| Practice Address |
5512 Del Maria Way Louisville KY 40291-1810 |
| Mailing Address |
5512 Delmaria Way Louisville KY 40291-1810 |
| Practice Telephone | 5023612301 |
| Practice Fax Number | 5023636114 |
| Mailing Telephone | 5023612301 |
| Mailing Fax Number | 5023636114 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2014-05-06 |
| Authorized Official Name | WENDY MORRIS (DEPUTY COMMISSIONER) |
| Authorized Official Telephone | 5025644527 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMONWEALTH OF KENTUCKY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 100694 | KY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 11906070 | 05 |
| Other Name | Type Code |
|---|---|
| Del Maria | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686900 | Commonwealth of Kentucky | Skilled Nursing Facility | 100 Veterans Drive, Radcliff, KY 40160 | 2015-08-14 |
| 1245657857 | Commonwealth of Kentucky | Clinic/Center | 2441 Us Highway 27, Somerset, KY 42501 | 2014-03-20 |
| 1730329897 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood, 2441 S. Hwy 27, Somerset, KY 42501 | 2009-03-03 |
| 1588804546 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 400 Eastwood Dr, 2441 S. Hwy 27, Somersetq, KY 42501 | 2009-03-03 |
| 1770762833 | Commonwealth of Kentucky | Residential Treatment Facility, Physical Disabilities | 5659 Main St, Thelma, KY 41260-8609 | 2007-10-25 |
| 1396962551 | Commonwealth of Kentucky | Nursing Facility/Intermediate Care Facility | 200 Veterans Dr, Hazard, KY 41701-9484 | 2007-04-19 |
| 1124144456 | Commonwealth of Kentucky | Pharmacy | 2400 Russellville Road, Hopkinsville, KY 42240 | 2007-03-21 |
| 1194862599 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 23524 Dawson Springs Rd, Dawson Springs, KY 42408-9205 | 2007-02-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1689652513 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 210 Meadows Dr, Mt Washington, KY 40047-6013 | 2005-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMONWEALTH OF KENTUCKY - DEPARTMENT FOR LOCAL GOVERNMENT | 1024 Capital Center Dr Ste 340, Frankfort, KY 40601-7514 |
| Street Address |
5512 DEL MARIA WAY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306017439 | The Academy for Individual Excellence, Inc. | Intermediate Care Facility, Mentally Retarded | 3101 Bluebird Ln, Louisville, KY 40299-3803 | 2008-03-17 |
| 1538356712 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 4230 Lesh St, Louisville, OH 44641-8605 | 2007-10-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1598721383 | Petersen Health Quality, LLC | Intermediate Care Facility, Mentally Retarded | 52 Old Rte 45, Louisville, IL 62858-0116 | 2006-04-21 |
| 1316241961 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-22 |
| 1275836124 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-15 |
| 1922233469 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2009-05-28 |
| 1467624288 | Voca Corporation of Florida | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2008-04-01 |
| 1700057833 | Alternative Youth Services, Inc. | Intermediate Care Facility, Mentally Retarded | 200 High Rise Dr, Suite 155, Louisville, KY 40213-3252 | 2008-03-17 |
| 1033197967 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2005-12-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40291 |
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| 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.