Individual provider Active NPI

Nicole Abbott

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1043587686
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3662 Issued in KY
Practice address
9702 Stonestreet Rd
#110
Louisville, KY 40272-6808
Phone
(502) 589-8600
Fax
(502) 589-8771
NPI assigned
Nov 28, 2011
Last updated
May 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3662 KY Primary

Addresses

Primary practice location

9702 Stonestreet Rd
#110
Louisville, KY 40272-6808

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423

Other identifiers 1

IdentifierTypeStateIssuer
7100290650MedicaidKY

Other names 1

  • Nicole Smith-Vires Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720002760 KY Practitioner - Clinical Social Worker 2062725047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Astra Behavioral Health LLCGroup PAC ID 0749406577, 35 clinicians

Practice addresses (Care Compare)

1013 Granite Dr
Bardstown, KY 40004-2013
Phone (502) 349-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Clinical CurrentSince May 9, 2015 Accepting new patients
Astra Behavioral Health LLC CurrentSince May 14, 2018 Accepting new patients

Locations

1013 Granite Dr
Bardstown, KY 40004
Phone (270) 506-2730

2000 Ring Rd
Elizabethtown, KY 42701
Phone (270) 506-2730

420 N Loretto Rd
Ste 200
Lebanon, KY 40033
Phone (270) 321-4480

101 W Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 589-8615

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

4010 DuPont Cir
Ste 210
Louisville, KY 40207
Phone (502) 694-4820

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

9702 Stonestreet Rd
Ste 110
Louisville, KY 40272
Phone (502) 589-8920

162 S Buckman St
Shepherdsville, KY 40165
Phone (502) 215-8770

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1043587686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9702 STONESTREET RD",
            "address_2": "#110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402726808",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100290650",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SMITH-VIRES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.