Active NPI
Andrea Lillian Collins Ratliff
- Community Health Worker
- Louisville, KY
National Provider Identifier
1053958793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 4835 Poplar Level Rd Ste 110
Louisville, KY 40213-2906 - Phone
- (855) 591-0092
- NPI assigned
- Dec 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
4835 Poplar Level Rd Ste 110
Louisville, KY 40213-2906
Mailing address
105 Anderson CT
Richmond, KY 40475-3200
Phone (606) 670-2165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1053958793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 ANDERSON CT",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404753200",
"telephone_number": "606-670-2165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4835 POPLAR LEVEL RD STE 110",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402132906",
"telephone_number": "855-591-0092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS RATLIFF",
"first_name": "ANDREA",
"middle_name": "LILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-02",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"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 Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.