COMMONWEALTH OF KENTUCKY (NPI# 1114346467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114346467 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | HAZELWOOD SPECIALTY CLINIC |
| Practice Address |
1800 Bluegrass Ave Louisville KY 40215-1130 |
| Practice Telephone | 5023612301 |
| Practice Fax Number | 5023660367 |
| Mailing Telephone | 5023612301 |
| Mailing Fax Number | 5023660367 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |
| 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 | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Hazelwood Specialty Clinic | Other Name - Individual/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 |
1800 BLUEGRASS AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40215-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982608543 | Lawrence G. Goldberg | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2005-06-10 |
| 1902376817 | Emily Kristen Mcwilliams | Physical Therapy Assistant | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-12-04 |
| 1174093090 | Ethan Cole Adams | Physical Therapist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-12-04 |
| 1902376825 | Jennifer Weiger | Occupational Therapy Assistant | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-12-04 |
| 1720558646 | Travis Petty | Physical Therapy Assistant | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-12-04 |
| 1467928895 | Lydia Coots | Physical Therapist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-10-24 |
| 1366937260 | Hayley Russell | Nurse Practitioner | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-06-25 |
| 1508358359 | Ashley Newton | Nurse Practitioner | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2018-06-06 |
| 1316458987 | Lydia Coughlin | Speech-Language Pathologist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2017-10-23 |
| 1073062634 | Ashley Nicole Hill | Speech-Language Pathologist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2016-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417473315 | Robin Jones | Behavioral Analyst | 800 W. Woodlawn Ave, Louisville, KY 40215 | 2017-08-22 |
| 1316332448 | Christopher Fenzel | Emergency Medicine | 1850 Bluegrass Avenue, Louisville, KY 40215 | 2015-04-06 |
| 1447661210 | Khac Phuong Vu | Dentist | 3448 Taylor Boulevard, Louisville, KY 40215 | 2014-05-15 |
| 1619251238 | Scott H Kaminsky | Marriage & Family Therapist | 3535 Taylor Blvd, Louisville, KY 40215 | 2011-09-30 |
| 1821313529 | Taylor Blvd Chiropractic | Chiropractor | 3254 Taylor Blvd, Louisville, KY 40215 | 2010-04-06 |
| 1396985131 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4419 Lasalle Ave, Louisville, KY 40215 | 2009-03-05 |
| 1841448735 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4418 Malcolm Ave., Louisville, KY 40215 | 2008-09-04 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1801911680 | Timothy John Lutes | Dentist | 3205 Taylor Blvd, Louisville, KY 40215 | 2007-03-20 |
| 1063557346 | Louisville-jefferson County Metro Government | Public Health or Welfare | 4255 Hazelwood Avenue, Louisville, KY 40215 | 2007-02-21 |
| Find all providers in zip 40215 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036210 | Emerge Rehab & Wellness,llc | Clinic/Center | 3501 Fenwick Park Pl Apt F, Louisville, KY 40220-5844 | 2020-02-25 |
| 1952940215 | Kentucky Center for Regenerative Medicine, LLC | Clinic/Center | 4010 Dupont Cir Ste 203, Louisville, KY 40207-4847 | 2020-01-03 |
| 1497227060 | Quality Urgent Care Professional Corporation | Clinic/Center | 1335 E South Boulder Rd Ste C, Louisville, CO 80027-2304 | 2018-12-20 |
| 1700313293 | Complete Laser Clinic of Louisville, LLC | Clinic/Center | 3000 Fern Valley Rd, Louisville, KY 40213-3522 | 2017-05-16 |
| 1356898373 | Baptist Health Employer Solutions, Inc | Clinic/Center | 2501 Nelson Miller Pkwy Ste 102, Louisville, KY 40223-2221 | 2016-09-07 |
| 1548877491 | Crossover Health Medical Group | Clinic/Center | 4813 Dixie Hwy, Louisville, KY 40216-2503 | 2020-09-24 |
| 1093341497 | Uofl Health-louisville Inc | Clinic/Center | 3920 Dutchmans Ln, Louisville, KY 40207-4020 | 2020-03-17 |
| 1144856543 | Uofl Health-louisville Inc | Clinic/Center | 2401 Terra Crossing Blvd, Louisville, KY 40245-5371 | 2020-03-17 |
| 1699308452 | Boulder Medical Center, P.C. | Clinic/Center | 80 Health Park Dr Ste 100, Louisville, CO 80027-4644 | 2020-02-19 |
| 1780101873 | Prorehab of Louisville LLC | Clinic/Center | 8019 Dixie Hwy Ste 106, Louisville, KY 40258-1303 | 2017-08-29 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40215 |
Please comment or provide details below to improve the information on COMMONWEALTH OF KENTUCKY.
| 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.