NPIMap

Organization Active NPI

Commonwealth of Kentucky

  • Occupational Therapy Assistant
  • Louisville, KY
National Provider Identifier
1023479250
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
A2460 Issued in KY
Legal business name
COMMONWEALTH OF KENTUCKY
Practice address
4501 Louise Underwood Way
Louisville, KY 40216-3987
Phone
(502) 368-2348
Fax
(502) 371-9067
NPI assigned
Mar 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Tanyika Wan, RHIT
Title
Cao
Phone
(502) 368-2348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X A2460 KY Primary

Addresses

Primary practice location

4501 Louise Underwood Way
Louisville, KY 40216-3987

Mailing address

4501 Louise Underwood Way
Louisville, KY 40216-3987
Phone (502) 368-2348

Other names 1

  • Lee Specialty Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Liberty Elementary126 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

4501 Louise Underwood Way
Louisville, KY 40216
Phone (502) 368-2348

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1023479250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 LOUISE UNDERWOOD WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402163987",
            "telephone_number": "502-368-2348",
            "fax_number": "502-371-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 LOUISE UNDERWOOD WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402163987",
            "telephone_number": "502-368-2348",
            "fax_number": "502-371-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF KENTUCKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "WAN",
        "authorized_official_first_name": "TANYIKA",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "502-368-2348",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "A2460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.