PEDIATRIC GASTROENTEROLOGY PSC (NPI# 1164455952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164455952 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC GASTROENTEROLOGY PSC |
| Practice Address |
233 E Gray St Suite 513 Louisville KY 40202-2026 |
| Practice Telephone | 5026295796 |
| Practice Fax Number | 5026295799 |
| Mailing Telephone | 5026295796 |
| Mailing Fax Number | 5026295799 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2008-05-06 |
| Authorized Official Name | THGMAS C STEPHEN (PRESIDENT) |
| Authorized Official Telephone | 5026295796 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | `0424168 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 65927816 | 05 | |
| IN | 200140610A | 05 | |
| KY | PASSPORT GROUP NUMBER | 1049092 | 01 |
| Street Address |
233 E GRAY ST SUITE 513 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629070214 | Michelle Phuong Le | Anesthesiology | 233 E Gray St, Suite 804, Med Tower, Louisville, KY 40202-2026 | 2005-08-12 |
| 1033292024 | Ronnie Bower | Nurse Anesthetist, Certified Registered | 233 E Gray St, Suite 804, Louisville, KY 40202-2026 | 2006-10-23 |
| 1477635696 | Tammy Rothrock | Nurse Anesthetist, Certified Registered | 233 E Gray St, Suite 804, Louisville, KY 40202-2026 | 2006-10-19 |
| 1023100906 | Kavita Mehta | Anesthesiology | 233 E Gray St, Louisville, KY 40202 | 2006-09-29 |
| 1669564472 | David Robinson | Nurse Anesthetist, Certified Registered | 233 E Gray St, Louisville, KY 40202-2026 | 2006-09-29 |
| 1164514972 | Jennifer Paul | Nurse Anesthetist, Certified Registered | 233 E Gray St, Suite 804, Louisville, KY 40202-2026 | 2006-09-29 |
| 1154413979 | George Sivert | Nurse Anesthetist, Certified Registered | 233 E Gray St, Louisville, KY 40202-2026 | 2006-09-29 |
| 1598857302 | Amy Culwell | Nurse Anesthetist, Certified Registered | 233 E Gray St, Louisville, KY 40202-2026 | 2006-09-29 |
| 1902998701 | Jason Delaluz | Nurse Anesthetist, Certified Registered | 233 E Gray St, Suite 804, Louisville, KY 40202-2026 | 2006-09-29 |
| 1982657813 | Validus Health, Pllc | Specialist | 233 E Gray St, Suite 804, Louisville, KY 40202-2026 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104317734 | Usimc of West Virginia Medical Corporation | Clinic/Center | 908 W Broadway Fl 8, Louisville, KY 40203 | 2018-05-18 |
| 1235644287 | First Care Chiropractic Center Psc | Clinic/Center | 5057 Poplar Level Rd Ste 7, Louisville, KY 40219-1129 | 2017-12-12 |
| 1467993709 | Ky Pt Pllc | Clinic/Center | 5520 Fern Valley Rd Ste 108, Louisville, KY 40228-1088 | 2017-03-20 |
| 1366996449 | Ecare, P.s.c. | Clinic/Center | 9201 Linn Station Rd, Louisville, KY 40222-5726 | 2016-08-06 |
| 1386019495 | Advanced Diagnostic Fna Biopsy Clinic, LLC | Clinic/Center | 400 S. Mccaslin Blvd., Suite 213, Louisville, CO 80027 | 2015-12-01 |
| 1265606222 | Kort-kentucky Orthopedic Rehab Team | Clinic/Center | 3901 Dutchmans Ln Ste 104, Louisville, KY 40207-4726 | 2008-04-21 |
| 1144405770 | C. Douglas Hensley | Clinic/Center | 305b Middletown Park Pl, Louisville, KY 40243-2514 | 2008-01-02 |
| 1881896710 | Hafendorfer, Pllc | Clinic/Center | 10629 Henning Way, 6, Louisville, KY 40241-2085 | 2007-06-04 |
| 1922124148 | Evans Chiropractic Psc | Clinic/Center | 3071 Breckenridge Ln, Louisville, KY 40220-2101 | 2007-03-21 |
| 1063561702 | Kentucky Easter Seal Society Inc | Clinic/Center | 9810 Bluegrass Parkway, Louisville, KY 40299 | 2007-01-10 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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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.