21ST CENTURY ONCOLOGY OF KENTUCKY LLC (NPI# 1649779455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649779455 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY ONCOLOGY OF KENTUCKY LLC |
| Other Organization Name | CANCER & BLOOD SPECIALISTS OF KENTUCKY |
| Practice Address |
1460 Bluegrass Ave Louisville KY 40215-1272 |
| Mailing Address |
2270 Colonial Blvd Fort Myers FL 33907-1412 |
| Practice Telephone | 5023618496 |
| Mailing Telephone | 2393331701 |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | MELISSA MCDONALD (PROJECT MNGR/APPLICATIONS TRAINER) |
| Authorized Official Telephone | 2394618546 |
| Is Organization Subpart | Y |
| Parent Organization Name | 21ST CENTURY ONCOLOGY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| CANCER & BLOOD SPECIALISTS OF KENTUCKY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124008677 | 21st Century Oncology of Kentucky LLC | Radiology | 520 Techwood Drive N, Danville, KY 40422-8500 | 2006-01-20 |
| 1922520808 | 21st Century Oncology of Kentucky LLC | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2017-07-12 |
| Street Address |
1460 BLUEGRASS AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40215-1272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609876978 | Michael G Carroll | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2005-07-28 |
| 1669931259 | American Oncology Partners, P.a. | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2019-03-14 |
| 1922520808 | 21st Century Oncology of Kentucky LLC | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2017-07-12 |
| 1861545287 | M G Carroll,& S P Sheth Ptrs | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2007-01-19 |
| 1790710481 | Mohammad I. Khan | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2006-07-11 |
| 1316948995 | Vijay M Raghavan | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2005-08-09 |
| 1942201652 | Subhash P Sheth | Internal Medicine | 1460 Bluegrass Ave, Louisville, KY 40215-1272 | 2005-08-03 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861752644 | Jencare Neighborhood Medical Center Newburg, LLC | Non-Pharmacy Dispensing Site | 1918 Hikes Ln, Louisville, KY 40218-2598 | 2012-05-25 |
| 1710243860 | Green Horseshoe Healthcare | Non-Pharmacy Dispensing Site | 2145 W Hill St, Louisville, KY 40210-1923 | 2012-04-03 |
| 1982144358 | Orthopaedic Specialists Pllc | Non-Pharmacy Dispensing Site | 4001 Kresge Way, Suite 330, Louisville, KY 40207-4640 | 2017-03-03 |
| 1245606631 | Dynamic Medical and Rehab, LLC | Non-Pharmacy Dispensing Site | 3707 Chamberlain Ln, Ste 101, Louisville, KY 40241-2001 | 2015-08-19 |
| 1386078491 | Jeffrey V. Chou, Dpm | Non-Pharmacy Dispensing Site | 117 S Hubbards Ln, Louisville, KY 40207-3900 | 2013-08-26 |
| 1750641536 | Dr Kusum T Nigam Internal Medicine Pllc | Non-Pharmacy Dispensing Site | 4402 Churchman Ave, Ste 410, Louisville, KY 40215-1190 | 2012-05-25 |
| 1740540525 | Jencare Neighborhood Medical Center West Broadway, LLC | Non-Pharmacy Dispensing Site | 2406 W Broadway, Louisville, KY 40211-1008 | 2012-05-25 |
| 1295091999 | Jencare Neighborhood Medical Valley Station, LLC | Non-Pharmacy Dispensing Site | 8019 Dixie Hwy, Ste 101, Louisville, KY 40258-1344 | 2012-04-06 |
| 1730445636 | Amin's Family Practice Associates, Psc | Non-Pharmacy Dispensing Site | 1505 S 7th St, Louisville, KY 40208-1710 | 2012-04-04 |
| 1457418832 | Ravi S Gill Md | Non-Pharmacy Dispensing Site | 907 Lyndon Ln, Louisville, KY 40222-3815 | 2007-01-03 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40215 |
Please comment or provide details below to improve the information on 21ST CENTURY ONCOLOGY OF KENTUCKY 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.