BOKHODIR S MAMEDOV (NPI# 1417482357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417482357 |
| Entity Type | Individual |
| Full Name | BOKHODIR S MAMEDOV |
| Practice Address |
3812 Stone River Ct Louisville KY 40299-6543 |
| Mailing Address |
3812 Sone River Ct Louisville KY 40299-9100 |
| Practice Telephone | 5028513268 |
| Mailing Telephone | 5028513268 |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3812 STONE RIVER CT |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40299-6543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477050144 | Jolanta Staniszewska | Social Worker | 1700 Cargo St, Louisville, KY 40299 | 2018-04-10 |
| 1780192302 | Chris Mcclain | Pharmacist | 1901 Campus Place, Suite 100, Louisville, KY 40299 | 2018-01-17 |
| 1669984209 | Bluegrass Allergy Asthma and Immunology Psc | Internal Medicine | 11900 Plantside Dr Ste 9, Louisville, KY 40299 | 2017-11-03 |
| 1588182109 | Hollie Marie Wheeler | Speech-Language Pathologist | Paragon Rehabilitation 2701 Chesnut Station Court, Louisville, KY 40299 | 2017-09-04 |
| 1790206464 | Farrah Hill Rodgers | Occupational Therapy Assistant | 2701 Chestnut Station Court., Paragon Rehabilitation, Louisville, KY 40299 | 2017-07-03 |
| 1871972620 | Jag Medical LLC | Pharmacy | 9813 Merioneth Dr, Louisville, KY 40299 | 2015-05-27 |
| 1023496205 | Scotty Ray Newcomer | Family Medicine | 8511 Watterson Trl, Louisville, KY 40299 | 2015-05-08 |
| 1386048262 | Daniel Gerhard Eschenbach | Dentist | 12613 Taylorsville Rd., Suite #17, Louisville, KY 40299 | 2014-10-21 |
| 1740616192 | Alyse C Martin | Nurse Practitioner | 9569 Taylorsville Road Suite 109, Louisville, KY 40299 | 2013-09-17 |
| 1407104128 | Tammy Rowland Reddington | Nurse Practitioner | 4004 Hurstbroune Woods Drive, Louisville, KY 40299 | 2012-08-28 |
| Find all providers in zip 40299 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566553 | Kenley N Joelson | Student in an Organized Health Care Education/Training Program | 2400 S 4th St Unit 710, Louisville, KY 40208-1526 | 2020-10-21 |
| 1235746512 | Nina S Smith | Student in an Organized Health Care Education/Training Program | 1115 Garvin Pl # 120, Louisville, KY 40203-3178 | 2020-09-30 |
| 1215541834 | Sarah Sloan Goldberg | Student in an Organized Health Care Education/Training Program | 11201 Bodley Dr, Louisville, KY 40223-1387 | 2020-09-01 |
| 1396361630 | Teylor Elizabeth Harrity | Student in an Organized Health Care Education/Training Program | 123 Woodruff 5 Rd, Louisville, MS 39339-7740 | 2020-06-23 |
| 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 |
| 1790308161 | Sue Ann Heironimus | Student in an Organized Health Care Education/Training Program | 7516 Creekton Dr, Louisville, KY 40241-6430 | 2020-05-20 |
| 1780207274 | Isabel Misha Vyazmensky | Student in an Organized Health Care Education/Training Program | 2211 S Brook St Room 105, Louisville, KY 40292-2442 | 2020-05-19 |
| 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 |
| 1831711027 | James Stephen Stotts | Student in an Organized Health Care Education/Training Program | 3018 Carson Way, Louisville, KY 40205-3116 | 2020-05-11 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40299 |
Please comment or provide details below to improve the information on BOKHODIR S MAMEDOV.
| 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.