METRO PROVIDERS, PLLC (NPI# 1811152713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811152713 |
| Entity Type | Organization |
| Organization Name | METRO PROVIDERS, PLLC |
| Other Organization Name | DYNAMIC MEDICAL & REHAB |
| Practice Address |
3707 Chamberlain Ln Suite 101 Louisville KY 40241-2001 |
| Practice Telephone | 5024269200 |
| Practice Fax Number | 5024269259 |
| Mailing Telephone | 5024269200 |
| Mailing Fax Number | 5024269259 |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2008-09-08 |
| Authorized Official Name | DR. MARK T HENDERSON (OWNER) |
| Authorized Official Telephone | 5024269200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 4390 | KY | Chiropractic Providers |
| Y | 208D00000X | General Practice | 33009 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64330095 | 05 |
| Other Name | Type Code |
|---|---|
| Dynamic Medical & Rehab | Doing Business As Name - Organization |
| Street Address |
3707 CHAMBERLAIN LN SUITE 101 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598844375 | Dr Paul J Constante Dc Psc | Chiropractor | 3707 Chamberlain Ln, Suite 101, Louisville, KY 40241-2091 | 2006-11-03 |
| 1245606631 | Dynamic Medical and Rehab, LLC | Non-Pharmacy Dispensing Site | 3707 Chamberlain Ln, Ste 101, Louisville, KY 40241-2001 | 2015-08-19 |
| 1033482260 | Glenn Rudolph | Dentist | 3707 Chamberlain Ln, Suite 103, Louisville, KY 40241-2001 | 2012-02-19 |
| 1174644421 | Anthony Rhoden Clark | Dentist | 3707 Chamberlain Ln, Suitte 103, Louisville, KY 40241-2001 | 2007-04-03 |
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144876814 | You Only Live Once Medical | General Practice | 821 Ulrich Ave, Louisville, KY 40219-1844 | 2019-08-17 |
| 1760979124 | Healthy Living Primary Care | General Practice | 4400 Breckenridge Ln Ste 147, Louisville, KY 40218 | 2018-04-20 |
| 1639603145 | Charita Weathers | General Practice | 401 East Chestnut, Ste 610, Louisville, KY 40202 | 2017-04-12 |
| 1528519113 | A New Journey | General Practice | 4100 Cadillac Ct, Louisville, KY 40213-1591 | 2016-10-18 |
| 1013381441 | Veloz Medical Services Corp | General Practice | 6911 Shepherdsville Rd, Louisville, KY 40219-2211 | 2015-11-23 |
| 1407229545 | Fern Medical and Rehab Corp | General Practice | 5520 Fern Valley Rd, 107, Louisville, KY 40228-1087 | 2015-11-12 |
| 1245616960 | Gerald Michael Daiuto | General Practice | 13100 Rehl Rd, Louisville, KY 40299-4716 | 2015-08-04 |
| 1932586518 | Alexei Arkadievich Krainev | General Practice | 3107 Sunfield Cir, Louisville, KY 40241-6515 | 2015-05-02 |
| 1407263429 | Vlad Medical Ceneter | General Practice | 1400 Envoy Cir Ste 1416, Louisville, KY 40299-2896 | 2014-07-22 |
| 1366859530 | Ramid Med Center Corp | General Practice | 12305 Westport Rd Ste 106, Louisville, KY 40245-2712 | 2014-07-18 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40241 |
Please comment or provide details below to improve the information on METRO PROVIDERS, PLLC.
| 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.