PRACTICARE HOME CARE SERVICES, LLC (NPI# 1265943716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265943716 |
| Entity Type | Organization |
| Organization Name | PRACTICARE HOME CARE SERVICES, LLC |
| Practice Address |
1667 Russell Lee Dr Louisville KY 40211 |
| Mailing Address |
1667 Russell Lee Dr Louisville KY 40211-4305 |
| Practice Telephone | 5026090589 |
| Mailing Telephone | 5026090589 |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2020-04-15 |
| Authorized Official Name | DEPHANY BIBB (OWNER/PROVIDER) |
| Authorized Official Telephone | 5026090589 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100188560 | 05 | |
| KY | MEDICARE | K029120 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1667 Russell Lee Dr, Louisville, KY 402114305 | 5026090589 |
| Street Address |
1667 RUSSELL LEE DR |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942792940 | Kare LLC | Dentist | 2500 W Broadway Ste 500, Louisville, KY 40211 | 2018-06-05 |
| 1518478221 | Latoya Samantha Hall | Counselor | 646 South 36th Street, Louisville, KY 40211 | 2017-10-20 |
| 1003071200 | Mark Cassol Md Psc | Ophthalmology | 2600 W. Broadway, Suite 105, Louisville, KY 40211 | 2008-07-28 |
| 1194919548 | Hardin Housing Corp | Assisted Living Facility | 2035 S 41st St, Louisville, KY 40211 | 2007-08-29 |
| 1184770562 | Eta Day Care Center LLC | Case Management | 724 So 44th Street, Louisville, KY 40211 | 2007-01-26 |
| 1871571356 | Alice C Gunnison | Physician Assistant | 2406 West Broadway, Jencare Neighborhood Medical Center West Broadway, LLC, Louisville, KY 40211 | 2006-01-05 |
| 1730733783 | Mark A Bush | Nurse Practitioner | 3015 Wilson Ave, Louisville, KY 40211 | 2019-07-29 |
| 1407419237 | Gina M Beckford | Nurse Practitioner | 3015 Wilson Ave, Louisville, KY 40211 | 2019-04-17 |
| 1730694266 | Orchid House, Inc. | Early Intervention Provider Agency | 703 S 31st St, Louisville, KY 40211 | 2017-12-06 |
| 1609230085 | Christina Elizabeth Giles | Dentist | 3015 Wilson Ave, Louisville, KY 40211 | 2016-04-11 |
| Find all providers in zip 40211 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618535 | Pamela Nicole Kinney | Nurse Practitioner | 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 | 2020-10-26 |
| 1457950883 | Tetteh Narteh | Nurse Practitioner | 10200 Linn Station Rd Ste 125, Louisville, KY 40223-3889 | 2020-10-16 |
| 1114525540 | Richard A Anane | Nurse Practitioner | 10200 Linn Station Rd Ste 300, Louisville, KY 40223-3841 | 2020-10-16 |
| 1427656081 | Elma Mustic | Nurse Practitioner | 9714 Boxford Way, Louisville, KY 40242-2305 | 2020-10-15 |
| 1679171318 | Cassandra Jane Lee | Nurse Practitioner | 3416 Imperator Ln Unit 103, Louisville, KY 40245-7752 | 2020-10-14 |
| 1942817762 | Merritt Borders | Nurse Practitioner | 1602 Hunnington Pl Apt 4, Louisville, KY 40220-3771 | 2020-09-25 |
| 1114533536 | Lyssa Alexandra Miller | Nurse Practitioner | 5120 Dixie Hwy Ste 101, Louisville, KY 40216-1775 | 2020-09-21 |
| 1174138713 | Paola Cristina Maldonado | Nurse Practitioner | 14719 Eddington Way Apt 304, Louisville, KY 40245-5581 | 2020-09-10 |
| 1033722525 | Bynisha Robertson | Nurse Practitioner | 5312 Sprigwood Ln, Louisville, KY 40291-1135 | 2020-08-25 |
| 1154931202 | Heather M Karem | Nurse Practitioner | 10207 Hartley Dr, Louisville, KY 40223-2735 | 2020-08-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40211 |
Please comment or provide details below to improve the information on PRACTICARE HOME CARE SERVICES, LLC.
| 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.