South Oldham Family Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34317 Issued in KY

Legal business name

SOUTH OLDHAM FAMILY CARE

Practice address

6520 W Highway 22
Crestwood, KY 40014-9305

Phone

(502) 241-8488

Fax

(502) 241-7424

NPI assigned

Nov 4, 2011

Organization subpart

No

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

Authorized official

Name

Kamlesh Dave, M.D.

Title

Owner

Phone

(502) 241-8488

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1043597073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 W HIGHWAY 22",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149305",
            "telephone_number": "502-241-8488",
            "fax_number": "502-241-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 W HIGHWAY 22",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149305",
            "telephone_number": "502-241-8488",
            "fax_number": "502-241-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH OLDHAM FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "KAMLESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-241-8488",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "34317",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Renea Smith, PSYD
• SN Kentuckiana Rehab, LLC
• SN Kentuckiana Rehab, LLC
• Karin L Soltau, LCSW
• Hina Soni, PHARM D
• South Oldham Medical Clinic PSC
• Haley Deniese Spalding, BCBA
• Andrew Steele, O.D.
• Jennifer Stocker
• Misty M Stutz, PHARMD

• Family Medicine Physician in Crestwood, KY
• Providers in Crestwood, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.