Simplicity Health Nursing Home
Organization Active NPI Nurse Practitioner · Louisville, KY
NPI 1043095003 · NPPES record last updated Aug 29, 2023
Key facts
- NPI
- 1043095003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jacqueline Sanders
- Title
- Credentialing Administrator
- Phone
- (502) 630-2036
Practitioners 16
-
Marlon R Chagua, M.D.
-
Omari Chubinidze, MD
-
Crysta Devine, APRN
-
Andrea Lynn Ohr, APRN
-
Starr Padron-Harris, APRN
-
Sara Louise Perry, APRN
-
Rayshunale Marie Smith, APRN
-
Tanisha Monique Williams, FNP-C
-
Hayley Bussey, APRN
-
Carla Brewer, DNP, MSN-APRN-BC
-
Dallas L Demaree, APRN
-
Uzma Uppal, M.D.
-
Krishna Gathani, DPM
-
Janessa Marie James, APRN
-
Nina L Smith Johnson, DNP, APRN, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231229000968 | KY | Part B Supplier - Clinic/Group Practice | 2668822891 |
Receives reassigned benefits from 15 practitioners Practice locations: Louisville, KY |
National Provider Directory
Locations
104 Daventry Ln
Ste 1
Louisville, KY 40223
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
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
Other providers in Louisville, KY
- Ruth Margaret Simons
- Serenity Simons
- Shirley Simons
- Randy Jack Simpkins
- Simplicity Health Billing and Staffing LLC
- Simplicity Monitoring and Diagnostics LLC
- Simplicity Transitional Health LLC
- Simplistic Urgent Care, PLLC
- Simplistic Urgent Care, PLLC
- Alyssa Michele Simpson
All providers in Louisville, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.