Active NPI
Kentuckiana Pain Specialist Ambulatory Surgery Center
Doing business as KPS Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- KENTUCKIANA PAIN SPECIALIST AMBULATORY SURGERY CENTER
- Doing business as
- KPS Ambulatory Surgery Center
- Practice address
- 3710 Chamberlain LN Ste B
Louisville, KY 40241-2002 - Phone
- (502) 995-4004
- Fax
- (502) 933-5559
- NPI assigned
- Oct 2, 2017
- Last updated
- Oct 21, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ajith Nair, MD
- Title
- Medical Director
- Phone
- (502) 995-4004
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | KY36217 | KY | |
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
3710 Chamberlain LN Ste B
Louisville, KY 40241-2002
Mailing address
PO Box 24321
Louisville, KY 40224-0321
Phone (502) 995-4004
Other names 1
- KPS Ambulatory Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2149027 | Kentuckiana Pain Specialist | Certificate of waiver | May 22, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Kentuckiana Pain Specialist Ambulat | Infusion Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Implanted Infusion Pumps and/or Supplies|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Neurostimulators and/or Supplies|Surgical Dressings | Accepts assignment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Specialist
- Louisville, KY
- NPI 1073515227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1634774400000",
"number": "1083124366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24321",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402240321",
"telephone_number": "502-995-4004",
"fax_number": "502-933-5559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 CHAMBERLAIN LN STE B",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402412002",
"telephone_number": "502-995-4004",
"fax_number": "502-933-5559"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKIANA PAIN SPECIALIST AMBULATORY SURGERY CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-02",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A",
"authorized_official_last_name": "NAIR",
"authorized_official_first_name": "AJITH",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "502-995-4004",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "KY",
"license": "KY36217",
"primary": false
},
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "KPS Ambulatory Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Louisville, KY
- Kentuckiana Geriatric and Palliative Services PLLC
- Kentuckiana Medical Distributors, LLC
- Kentuckiana Mental Health Associates
- Kentuckiana Mobility Scooter Rental
- Kentuckiana Oral & Maxillofacial Surgery Assoc PSC
- Kentuckiana Pain Specialists PSC
- Kentuckiana Pain Specialists PSC (Kentuckiana Pain Specialists)
- Kentuckiana Perinatology PSC
- Kentuckiana Perinatology, PSC
- Kentuckiana Psychological Associates PLLC (BrainDocs)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.