NPIMap

Organization Active NPI

Simplicity Health Nursing Home

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1043095003
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SIMPLICITY HEALTH NURSING HOME
Practice address
104 Daventry LN Ste 2
Louisville, KY 40223-2883
Phone
(502) 445-7957
Fax
(502) 632-1432
NPI assigned
Aug 29, 2023
Last updated
Aug 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Mrs. Jacqueline Sanders
Title
Credentialing Administrator
Phone
(502) 630-2036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

104 Daventry LN Ste 2
Louisville, KY 40223-2883

Mailing address

104 Daventry LN Ste 2
Louisville, KY 40223-2883
Phone (502) 445-7957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231229000968 KY Part B Supplier - Clinic/Group Practice 2668822891 Receives reassigned benefits from 15 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

104 Daventry Ln
Ste 1
Louisville, KY 40223

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1043095003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DAVENTRY LN STE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232883",
            "telephone_number": "502-445-7957",
            "fax_number": "502-632-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DAVENTRY LN STE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232883",
            "telephone_number": "502-445-7957",
            "fax_number": "502-632-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLICITY HEALTH NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
        "authorized_official_telephone_number": "502-630-2036",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 29, 2023; 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.