DR. LIBBY WILSON MIMS (NPI# 1073855433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073855433 |
| Entity Type | Individual |
| Full Name | DR. LIBBY WILSON MIMS |
| Credential | M.D. |
| Practice Address |
115 Huston Dr Suite 2 Shepherdsville KY 40165-7250 |
| Mailing Address |
Po Box 776351 Chicago IL 60677-6351 |
| Practice Telephone | 5029558979 |
| Mailing Telephone | 5025889490 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2019-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 49331 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
115 HUSTON DR SUITE 2 |
| City | SHEPHERDSVILLE |
| State | KY |
| Zip Code | 40165-7250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003871518 | Stephen C. Payne | Family Medicine | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2006-04-18 |
| 1073168381 | Nathan Glen Hobbs | Physical Therapist | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2019-08-04 |
| 1528509460 | Amanda Jolene Parker | Nurse Practitioner | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2017-03-11 |
| 1851834295 | Ryan Hamilton | Physical Therapist | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2016-12-01 |
| 1992258347 | Christopher Hartlage | Physical Therapist | 115 Huston Dr, Suite 3, Shepherdsville, KY 40165-7250 | 2016-08-02 |
| 1477810687 | First Urology, Psc | Nurse Practitioner | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2012-04-12 |
| 1538337886 | Christina N. Caswell | Physical Therapist | 115 Huston Dr, Suite 3, Shepherdsville, KY 40165-7250 | 2008-02-20 |
| 1538295845 | Larry Madison Ryle | Internal Medicine | 115 Huston Dr, Shepherdsville, KY 40165-7250 | 2007-02-23 |
| 1518031269 | Heather A Potter | Nurse Practitioner | 115 Huston Dr, Suite 1, Shepherdsville, KY 40165-7250 | 2006-11-17 |
| 1629010889 | Charles Kevin Owens | Physical Therapist | 115 Huston Dr, Suite 3, Shepherdsville, KY 40165-7250 | 2006-06-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357729 | Jennifer Gayle Stillwell | Licensed Practical Nurse | 202 Overlook Estates Drive, Shepherdsville, KY 40165 | 2020-08-18 |
| 1538701537 | Melody Lynn Royer | Technician | 164 Beagle Run, Shepherdsville, KY 40165 | 2019-10-10 |
| 1649726258 | Kentucky Cvs Pharmacy LLC | Pharmacy | 157 South Buckman Street, Shepherdsville, KY 40165 | 2016-09-01 |
| 1669866729 | Ashley Krages | Occupational Therapy Assistant | 143b Turtle Bay Ct Apt 5, Shepherdsville, KY 40165 | 2015-03-26 |
| 1548679020 | Debra F Schoenberg | Social Worker | 1305 S. Joe B Hall, Shepherdsviile, KY 40165 | 2014-08-08 |
| 1821438359 | Jon-michael Leblanc | Counselor | 130 S. Joe B. Hall Ave., Shepherdsville, KY 40165 | 2013-06-28 |
| 1750633178 | Lee Alan Roussel | Marriage & Family Therapist | 130 Joe B Hall, Shepherdsville, KY 40165 | 2012-10-09 |
| 1679822977 | Andrew T. Webb | Social Worker | 130 South Joe B. Hall Ave., Shepherdsville, KY 40165 | 2012-08-31 |
| 1306173737 | Enrica T Thomas | Social Worker | 815 John Harper Rd Unit 14, Shepherdsville, KY 40165 | 2009-11-05 |
| 1740452184 | Brian Woodring | Marriage & Family Therapist | 130 Vine St., Shepherdsville, KY 40165 | 2008-03-26 |
| Find all providers in zip 40165 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538201892 | Casey Miles Lewis | Pediatrics | 1707 Cedar Grove Rd Ste 20, Shepherdsville, KY 40165-8592 | 2007-02-13 |
| 1619993466 | Sarah Renee Hart | Pediatrics | 1707 Cedar Grove Rd, 20, Shepherdsville, KY 40165-8572 | 2006-07-14 |
| 1215340187 | Sneha Pampati | Pediatrics | 115 Huston Dr Ste 1, Shepherdsville, KY 40165-7250 | 2014-06-08 |
| 1427324433 | Robert Caleb Buege | Pediatrics | 1707 Cedar Grove Rd Ste 20, Shepherdsville, KY 40165-8592 | 2012-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205452836 | Jenna M. Richards Do | Pediatrics | 793 Eastern Byp Ste 110, Richmond, KY 40475-2425 | 2020-06-19 |
| 1598384745 | Breckinridge Health Clinic | Pediatrics | 203b Fairgrounds Rd, Hardinsburg, KY 40143-2585 | 2020-04-08 |
| 1811533433 | Grace Community Health Center, Inc. | Pediatrics | 120 N Commonwealth Ave Ste 123&4, Corbin, KY 40701-6472 | 2019-11-19 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1477059657 | Advanced Care Pediatric Centre Pllc | Pediatrics | 1000 E Lexington Ave Ste 31, Danville, KY 40422-1707 | 2018-04-05 |
| 1396268223 | Prasanna Kumar Gangishetti | Pediatrics | 800 Rose St Rm No Mn-118, Lexington, KY 40536 | 2017-07-23 |
| 1154855054 | John Michael Jansen | Pediatrics | 3320 Tates Creek Rd Ste 302, Lexington, KY 40502-3400 | 2017-04-18 |
| 1396286407 | Alvarado Medical Services Pllc | Pediatrics | 25 E Hickman St, Winchester, KY 40391-2448 | 2017-03-09 |
| 1407218589 | Caitlyn Anglin | Pediatrics | University of Kentucky 800 Rose St Rm Mn 118, Lexington, KY 40536-1356 | 2016-03-28 |
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| City | SHEPHERDSVILLE |
| Zip Code | 40165 |
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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.