Med-Life-Fit Medical and Lifestyle Management Family Medical Center L

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34201 Issued in KY

Legal business name

MED-LIFE-FIT MEDICAL AND LIFESTYLE MANAGEMENT FAMILY MEDICAL CENTER L

Doing business as

Kentuckiana Medical Weight Loss Centers

Practice address

10512 Meeting St Ste 101
Prospect, KY 40059-7590

Phone

(502) 276-4706

NPI assigned

Jul 27, 2014

Organization subpart

No

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

Authorized official

Name

Lindsay Horn

Title

Office Manager

Phone

(502) 371-9700

Specialties & licenses 3

Addresses

Other names 1

• Kentuckiana Medical Weight Loss Centers Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Leigh O'Donnell, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1629578174
  NPD (past)
• Beth Lynn Willison, APRN, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1902325756
  NPD (past)

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

{
    "created_epoch": "1406419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1023426632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 MEETING ST STE 101",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400597590",
            "telephone_number": "502-276-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 MEETING ST STE 101",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400597590",
            "telephone_number": "502-276-4706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Brownsboro Rd",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402413900",
            "country_code": "US",
            "telephone_number": "502-276-4706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MED-LIFE-FIT MEDICAL AND LIFESTYLE MANAGEMENT FAMILY MEDICAL CENTER L",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-27",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-371-9700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "34201",
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "KY",
            "license": "34201",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentuckiana Medical Weight Loss Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kentuckiana Medical Weight Loss Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekah McIlvoy, MS, OTR/L
• Terence P McKenna, MD
• Rachel Brooks McKinley Jeffries, DPT
• Shelby Rene McWilliams, OTR/L
• MDH Management Group, Inc.
• Jennifer Metts
• Donna A. Meyer, P.T.
• Mian Consulting, Inc
• Milburn Services, Inc
• Sandra Meadows Milburn, P.T.

• Family Medicine Physician in Prospect, KY
• Providers in Prospect, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.