UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC (NPI# 1740518463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740518463 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC |
| Practice Address |
9700 Park Plaza Avenue Suite 110 Louisville KY 40241-2286 |
| Mailing Address |
Po Box 2469 Louisville KY 40201-2469 |
| Practice Telephone | 5026298821 |
| Practice Fax Number | 5026298824 |
| Mailing Telephone | 5028528500 |
| Mailing Fax Number | 5028528556 |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |
| Authorized Official Name | DR. GERARD P RABALAIS (CHAIRMAN) |
| Authorized Official Telephone | 5028528600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100010410 | 05 | |
| IN | 200889620 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013216936 | University Pediatric Endocrinology, LLC | Pediatrics | 720 2nd St, Ste 102, Bowling Green, KY 42101-1778 | 2011-03-17 |
| 1780983692 | University Pediatric Endocrinology, LLC | Dietitian, Registered | 811 E Parrish Ave, Ste 120, Owensboro, KY 42303-3258 | 2011-03-17 |
| 1417083437 | University Pediatric Endocrinology, LLC | Dietitian, Registered | 210 E Gray St, Ste 803, Louisville, KY 40202-3904 | 2007-02-26 |
| Street Address |
9700 PARK PLAZA AVENUE SUITE 110 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241-2286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386619146 | Patricia Collins Martin | Marriage & Family Therapist | 9700 Park Plaza Avenue, Suite 105, Louisville, KY 40241 | 2006-02-22 |
| 1568790277 | University Pediatric Gastroenterology, LLC | Pediatrics | 9700 Park Plaza Avenue, Suite 110, Louisville, KY 40241-2286 | 2009-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1952876146 | Ashley Lynne Johnson Belcher | Psychologist | 9700 Park Plaza Avenue, Ste. 106, Louisville, KY 40241 | 2018-10-04 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1346767472 | Bridgett Lin Youngblood | Case Manager/Care Coordinator | 4313 Brownsboro Glen Rd, Louisville, KY 40241 | 2017-08-29 |
| 1518375690 | Amir Shahla | Dentist | 10500 Fischer Park Dr, Louisville, KY 40241 | 2014-08-01 |
| 1255741781 | Alicia M Durham | Marriage & Family Therapist | 3900 Riveroaks Ln, Louisville, KY 40241 | 2014-05-06 |
| 1962826719 | Applied Behavioral Consulting, LLC | Community/Behavioral Health | 4517 Shenandoah Drive, Louisville, KY 40241 | 2014-02-14 |
| 1336579176 | Nicholas Weickel | Physical Therapist | 9880 Angie's Way, Suite 100, Louisville, KY 40241 | 2013-11-14 |
| Find all providers in zip 40241 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780737510 | Susan Raghavan | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2007-01-18 |
| 1659807881 | University of Louisville | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1835 | 2017-05-09 |
| 1093105306 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 601a, Louisville, KY 40202-3900 | 2015-01-26 |
| 1679985519 | Paul Hiers | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2014-05-27 |
| 1386070019 | Susan Raghavan, Md | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2013-09-26 |
| 1144586876 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 803, Louisville, KY 40202-3900 | 2012-04-06 |
| 1447530910 | Priyanka Bakhtiani | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1837 | 2011-08-27 |
| 1669765749 | Bradly Jackson Thrasher | Pediatrics | 411 E Chestnut St # St7, Louisville, KY 40202-1713 | 2011-05-23 |
| 1124159009 | Kupper Anthony Wintergerst | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811121692 | Evangelia Kalaitzoglou | Pediatrics | 2195 Harrodsburg Rd Ste 125, Lexington, KY 40504 | 2009-05-08 |
| 1023162492 | Wilburn Jackson Smith IIi | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2007-01-23 |
| 1326113234 | John Fowlkes | Pediatrics | 800 Rose St, Lexington, KY 40536-0001 | 2006-11-24 |
| 1346330909 | Alba E. Morales Pozzo | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1255421814 | Kathryn Thrailkill | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1568482826 | Charles Charlton Mabry | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2006-07-20 |
| City | LOUISVILLE |
| Zip Code | 40241 |
Please comment or provide details below to improve the information on UNIVERSITY PEDIATRIC ENDOCRINOLOGY, 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.