Kentucky Joint Specialists LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

KENTUCKY JOINT SPECIALISTS LLC

Practice address

4010 Dupont Cir Ste 310
Louisville, KY 40207-4834

Phone

(502) 771-5432

Fax

(502) 771-5430

NPI assigned

Oct 15, 2021

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Hartog

Title

Owner

Phone

(502) 771-5432

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Lea Blackburn, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1710502703

  Single Specialty

  Medicare reassignment NPD
• Wendy A. Mullins, P.T.

  • Physical Therapist
  • Louisville, KY
  • NPI 1588702724
  Medicare reassignment NPD
• Susan Scuffle, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1457839102
  Medicare reassignment NPD
• Laura Ellen Purdy, MD

  • Family Medicine Physician
  • Calabasas, CA
  • NPI 1093058463

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013670173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074834",
            "telephone_number": "502-771-5432",
            "fax_number": "502-771-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074834",
            "telephone_number": "502-771-5432",
            "fax_number": "502-771-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY JOINT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-15",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HARTOG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-771-5432"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kentucky Independent Support Services
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• Kentucky Injury Care Centers, LLC
• Kentucky Life Source Inc
• Kentucky Lions Eye Foundation, Inc.
• Kentucky Medical Specialists, PSC
• Kentucky Mental Health Care, L.L.C.
• Kentucky Neuro Associates

• Multi-Specialty Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Multi-Specialty Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.