PARK DUVALLE COMMUNITY HEALTH CENTER, INC (NPI# 1780698506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780698506 |
| Entity Type | Organization |
| Organization Name | PARK DUVALLE COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | PARK DUVALLE AT NEWBURG |
| Practice Address |
2237 Hikes Ln Louisville KY 40218-2203 |
| Mailing Address |
3015 Wilson Ave Louisville KY 40211-1969 |
| Practice Telephone | 5024798930 |
| Practice Fax Number | 5024798934 |
| Mailing Telephone | 5027744401 |
| Mailing Fax Number | 5027724783 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2017-10-10 |
| Authorized Official Name | ELIZABETH ANN HAGAN-GRIGSBY (CEO) |
| Authorized Official Telephone | 5027744401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
700005 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 31000011 | 05 |
| Other Name | Type Code |
|---|---|
| Park DuValle at Newburg | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151292 | Park Duvalle Community Health Center, Inc | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2020-07-07 |
| 1639727951 | Park Duvalle Community Health Center, Inc | Clinic/Center | 1130 W Chestnut St, Louisville, KY 40203-2047 | 2019-08-29 |
| 1811545403 | Park Duvalle Community Health Center, Inc | Clinic/Center | 5901 Greenwood Rd, Louisville, KY 40258-2409 | 2019-08-28 |
| 1851957252 | Park Duvalle Community Health Center, Inc | Clinic/Center | 75 Park Rd, Wing #1, New Castle, KY 40050-3095 | 2019-05-13 |
| 1518184613 | Park Duvalle Community Health Center, Inc | Pharmacy | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2007-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PARK DUVALLE COMMUNITY HEALTH CENTER, INC. | 3015 Wilson Ave, Louisville, KY 40211-1969 |
| Street Address |
2237 HIKES LN |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40218-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932669306 | Jessica Wren Deis | Nurse Practitioner | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2019-03-22 |
| 1770988800 | Krista Gail Roach | Nurse Practitioner | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2014-10-31 |
| 1316274814 | Beverly R Williams Coleman | Nurse Practitioner | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2009-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951170 | Okey Patrick Mbadike | Pharmacist | 3616 Buechal By Pass, Louisville, Ky 40218, Louisville, KY 40218 | 2020-10-30 |
| 1992339345 | Rachael P. Abell | Nurse Practitioner | 2210 Buechel Avenue Suite 105, Louisville, KY 40218 | 2020-02-25 |
| 1750938189 | Taylor C Thomas | Nurse Practitioner | 4423 Bardstown Road, Louisville, KY 40218 | 2019-08-21 |
| 1902461692 | Louisville Injury Clinics, Inc | Chiropractor | 4400 Breckenridge Lane, Suite 102, Louisville, KY 40218 | 2019-05-08 |
| 1629564141 | Stepping Stones Counseling | Social Worker | 5414 Bannon Crossing Dr, Louisville, KY 40218 | 2018-07-09 |
| 1396230553 | Kids Without Limits LLC | Home Health | 2204 Bashford Manor Ln, Louisville, KY 40218 | 2018-06-28 |
| 1073008074 | B F P D | Ambulance | 4101 Bardstown Rd, Louisville, KY 40218 | 2018-06-22 |
| 1508358862 | Mary Katherine Biros | Nurse Practitioner | 2202 Buechel Ave Ste 105, Louisville, KY 40218 | 2018-06-03 |
| 1366931644 | Irena Kuca | Student in an Organized Health Care Education/Training Program | 215 Central Avenue Suite 100, Louisville, KY 40218 | 2018-05-02 |
| 1760979124 | Healthy Living Primary Care | General Practice | 4400 Breckenridge Ln Ste 147, Louisville, KY 40218 | 2018-04-20 |
| Find all providers in zip 40218 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649732603 | Family Health Centers, Inc. | Clinic/Center | 4803 Southside Dr, Louisville, KY 40214-2111 | 2019-04-01 |
| 1578774477 | Family Health Centers, Inc. | Clinic/Center | 4805 Southside Dr, Louisville, KY 40214-2111 | 2007-05-24 |
| 1770680019 | Greater Meridian Health Clinic, Inc. | Clinic/Center | 14130 Highway 15 S Ste D, Louisville, MS 39339-6452 | 2006-09-20 |
| 1255354361 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 1015 W Chestnut St, Louisville, KY 40203-2048 | 2006-07-26 |
| 1275151292 | Park Duvalle Community Health Center, Inc | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2020-07-07 |
| 1639727951 | Park Duvalle Community Health Center, Inc | Clinic/Center | 1130 W Chestnut St, Louisville, KY 40203-2047 | 2019-08-29 |
| 1811545403 | Park Duvalle Community Health Center, Inc | Clinic/Center | 5901 Greenwood Rd, Louisville, KY 40258-2409 | 2019-08-28 |
| 1427574862 | Family Health Centers, Inc. | Clinic/Center | 2500 W Market St, Louisville, KY 40212-1541 | 2017-08-17 |
| 1245253160 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2006-07-25 |
| 1134172489 | Family Health Centers, Inc. | Clinic/Center | 834 E Broadway, Louisville, KY 40204-1072 | 2006-05-18 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40218 |
Please comment or provide details below to improve the information on PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
| 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.