NPIMap

Organization Active NPI

Commonwealth of Kentucky

Doing business as Del Maria

  • Intellectual Disabilities Intermediate Care Facility
  • Louisville, KY
National Provider Identifier
1043298979
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
100694 Issued in KY
Legal business name
COMMONWEALTH OF KENTUCKY
Doing business as
Del Maria
Practice address
5512 Del Maria Way
Louisville, KY 40291-1810
Phone
(502) 361-2301
Fax
(502) 363-6114
NPI assigned
Dec 30, 2005
Last updated
Aug 7, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMONWEALTH OF KENTUCKYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Jennifer Moore
Title
Assistant Director
Phone
(502) 782-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 100694 KY Primary

Addresses

Primary practice location

5512 Del Maria Way
Louisville, KY 40291-1810

Mailing address

5512 Delmaria Way
Louisville, KY 40291-1810
Phone (502) 361-2301

Other identifiers 1

IdentifierTypeStateIssuer
11906070MedicaidKY

Other names 1

  • Del Maria Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043298979. Details of each certification follow.

  • CCN 18G011 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 18G011

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DEL MARIA ICF/IID
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 27, 1995
Last certification
Aug 7, 2025
Beds
8
Ownership / control type
State
Facility address
5512 Del Maria Way
Louisville, KY 40291

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D1029332Del Maria Icf/Mr5512 Del Maria Way, Louisville, KY 40291Certificate of waiverAug 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Anderson County Health Dept126 organizations share this tax ID, including this one
Part of
Anderson County Health Dept

Organizations with this tax ID in the same state 18

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

View all 18

Locations

5512 Delmaria Way
Louisville, KY 40291
Phone (502) 361-2301

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1043298979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 DELMARIA WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911810",
            "telephone_number": "502-361-2301",
            "fax_number": "502-363-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 DEL MARIA WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911810",
            "telephone_number": "502-361-2301",
            "fax_number": "502-363-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF KENTUCKY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMONWEALTH OF KENTUCKY",
        "enumeration_date": "2005-12-30",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "502-782-6117"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "KY",
            "license": "100694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11906070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Maria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.