NPIMap

Individual provider Active NPI

Charlotte Kay Ingwersen, M.D.

  • Family Medicine Physician
  • Shepherdsville, KY
National Provider Identifier
1003810987
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32033 Issued in KY
Practice address
187 Adam Shepherd Pkwy Ste 5
Shepherdsville, KY 40165-7500
Phone
(502) 543-4119
Fax
(502) 543-1462
NPI assigned
Jun 9, 2005
Reactivated
Mar 24, 2006
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32033 KY Primary

Addresses

Primary practice location

187 Adam Shepherd Pkwy Ste 5
Shepherdsville, KY 40165-7500

Mailing address

100 E Liberty St
Suite 800
Louisville, KY 40202-1434
Phone (502) 543-4119

Other identifiers 1

IdentifierTypeStateIssuer
64320336MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000314 KY Practitioner - Family Practice 2466473988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

215 Central Ave
Suite 100
Louisville, KY 40208-1450
Phone (502) 588-8720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32033KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Oct 7, 2019 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
University of Louisville Physicians, Inc. Family Medicine CurrentSince Oct 7, 2019 Accepting new patients
Bullitt County Family Care Center, PLLC Past Accepting new patients
Komg-Louisville Region Inc. Family Medicine Past Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
Bullitt County Family Care Center, P.L.L.C. PastSince Aug 18, 2003 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

170 Dr Arla Way
Ste 101
Louisville, KY 40229
Phone (502) 888-1988

215 Central Ave
Ste 100
Louisville, KY 40208
Phone (502) 588-8720

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

187 Adam Shepherd Pkwy
Ste 5
Shepherdsville, KY 40165
Phone (502) 543-4119

Networks

  • KY PPO
  • TN PPO C-SNP
  • KY PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • OH PPO
  • TN PPO

Interoperability endpoints

  • Direct secure messaging: cingwersen13766@uoflhealth-dm.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1003810987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-543-4119",
            "fax_number": "502-543-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 ADAM SHEPHERD PKWY STE 5",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657500",
            "telephone_number": "502-543-4119",
            "fax_number": "502-543-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGWERSEN",
        "first_name": "CHARLOTTE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2018-03-21",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "32033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64320336",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.