Individual provider Active NPI

Brenda Sue Foreman, ARNP-CS

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1073658902
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4484S Issued in KY
Practice address
315 E Broadway
Louisville, KY 40202-3700
Phone
(502) 629-2500
Fax
(502) 629-2055
NPI assigned
Feb 20, 2007
Last updated
Mar 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4484S KY Primary

Addresses

Primary practice location

315 E Broadway
Louisville, KY 40202-3700

Mailing address

315 E Broadway
Louisville, KY 40202-3700
Phone (502) 629-2500

Other identifiers 3

IdentifierTypeStateIssuer
50026824OtherKYPASSPORT HEALTH PLANS
78007044MedicaidKY
4484SOtherKYARNP LICENSE NUMBER

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
4484SKYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1073658902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023700",
            "telephone_number": "502-629-2500",
            "fax_number": "502-629-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023700",
            "telephone_number": "502-629-2500",
            "fax_number": "502-629-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "BRENDA",
        "middle_name": "SUE",
        "credential": "ARNP-CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4484S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLANS",
            "identifier": "50026824",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78007044",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "4484S",
            "state": "KY"
        }
    ],
    "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 Mar 1, 2010; 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.