COMMONWEALTH OF KENTUCKY (NPI# 1578871679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578871679 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF KENTUCKY |
| Other Organization Name | CENTRAL STATE HOSPITAL |
| Practice Address |
10510 Lagrange Road Louisville KY 40223 |
| Practice Telephone | 5022537000 |
| Practice Fax Number | 5032537044 |
| Mailing Telephone | 5022537000 |
| Mailing Fax Number | 5032537044 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2015-07-16 |
| Authorized Official Name | STEPHANIE CRAYCRAFT (DIRECTOR) |
| Authorized Official Telephone | 5027826243 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMONWEALTH OF KENTUCKY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| Y | 283Q00000X | Psychiatric Hospital | KY | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 02021293 | 05 |
| Other Name | Type Code |
|---|---|
| Central State Hospital | Doing Business As Name - 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 |
10510 LAGRANGE ROAD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851440267 | Denise L Epperson | Psychiatry & Neurology | 10510 Lagrange Road, Louisville, KY 40223-1228 | 2007-01-09 |
| 1598056210 | Commonwealth of Kentucky | Psychiatry & Neurology | 10510 Lagrange Road, Louisville, KY 40223 | 2011-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235605668 | Ashlee Brooke Colville | Counselor | 13121 Esat Point Park Blvd, Suite F, Louisville, KY 40223 | 2018-10-24 |
| 1831619758 | Tracie S Lain | Developmental Therapist | 13101 Eastpoint Park Blvd., Louisville, KY 40223 | 2017-06-21 |
| 1972051399 | Ruby Denise Brooks | Counselor | 1407 Lafontenay Ct, Louisville, KY 40223 | 2016-09-14 |
| 1427409085 | Victoria Krepps Terrell | Nurse Practitioner | 13301 Shelbyville Rd Ste 103, Louisville, KY 40223 | 2016-06-24 |
| 1033570098 | Mackenzie Sipes | Chiropractor | 401 Creason Ct Unit 205, Louisville, KY 40223 | 2016-03-17 |
| 1699151258 | Chelsey Layne Gorham | Marriage & Family Therapist | 13121 Eastpoint Park Blvd Ste F, Louisville, KY 40223 | 2015-08-06 |
| 1356764187 | Paula Renee Garner | Social Worker | 1015 Dorsey Lane, Louisville, KY 40223 | 2014-01-30 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| 1417392259 | Lauren Parsons Berry | Dentist | 9780 Ormsby Station Rd, Suite 1200, Louisviile, KY 40223 | 2013-05-07 |
| 1336486653 | Lynn M Pendley | Dietitian, Registered | 9400 Mill Brook Rd, Northeast Ymca, Louisville, KY 40223 | 2013-01-07 |
| Find all providers in zip 40223 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558343566 | Parkwest Medical Center | Psychiatric Hospital | 2347 Jones Bend Rd, Louisville, TN 37777-5213 | 2005-11-16 |
| 1366447609 | Central State Hospital | Psychiatric Hospital | 10510 Lagrange Rd, Louisville, KY 40223-1277 | 2005-06-14 |
| 1275953754 | Tbd Acquisition, LLC | Psychiatric Hospital | 1405 Browns Ln, Louisville, KY 40207-4608 | 2014-04-23 |
| 1760623888 | Uhs of Centennial Peaks LLC | Psychiatric Hospital | 2255 S 88th St, Louisville, CO 80027-9716 | 2009-03-19 |
| 1417167131 | Caritas Peace Center | Psychiatric Hospital | 2020 Newburg Rd, Louisville, KY 40205-1803 | 2007-05-23 |
| 1124237375 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Hospital | 2020 Newburg Rd, Louisville, KY 40205-1803 | 2007-05-22 |
| 1407972615 | Flatirons Behavioral Health | Psychiatric Hospital | 2255 S 88th St, Louisville, CO 80027-9716 | 2007-03-21 |
| 1447350160 | Diamond Grove Center | Psychiatric Hospital | 2311 Highway 15 S, Louisville, MS 39339-7071 | 2006-09-23 |
| 1265530034 | Central State Hospital Pharmacy | Psychiatric Hospital | 10510 Lagrange Rd, Louisville, KY 40223-1277 | 2006-09-20 |
| 1588601991 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Hospital | 1850 Bluegrass Ave, Louisville, KY 40215-1161 | 2006-06-02 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40223 |
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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.