Individual provider Active NPI

Angela Rambalakos Pecha, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1104919281
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
KY 31588 Issued in KY
Practice address
8134 New Lagrange Rd
Ste 101
Louisville, KY 40222-4676
Phone
(502) 412-0597
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X KY 31588 KY Primary

Addresses

Primary practice location

8134 New Lagrange Rd
Ste 101
Louisville, KY 40222-4676

Mailing address

206 Pepperbush Rd
Louisville, KY 40207-5714
Phone (502) 394-9490

Other identifiers 3

IdentifierTypeStateIssuer
50013898OtherKYPASSPORT
64951429MedicaidKY
000000501933OtherKYANTHEM

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
KY 31588KYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1104919281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PEPPERBUSH RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075714",
            "telephone_number": "502-394-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8134 NEW LAGRANGE RD",
            "address_2": "STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224676",
            "telephone_number": "502-412-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHA",
        "first_name": "ANGELA",
        "middle_name": "RAMBALAKOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "KY 31588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50013898",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64951429",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000501933",
            "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 Nov 13, 2008; 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.