Kyppec,Inc

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

760001 Issued in KY

Legal business name

KYPPEC,INC

Doing business as

The Kidz Club

Practice address

1101 Herr LN
Louisville, KY 40222-4301

Phone

(502) 210-5538

Fax

(502) 327-5098

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Lee B Zimmerman

Title

Pres

Phone

(502) 210-5538

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Kidz Club Doing business as

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1114052057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HERR LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224301",
            "telephone_number": "502-210-5538",
            "fax_number": "502-327-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HERR LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224301",
            "telephone_number": "502-210-5538",
            "fax_number": "502-327-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYPPEC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "502-210-5538",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "KY",
            "license": "760001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45000098",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY PASSPORT PROVIDER NUMB",
            "identifier": "50000542",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidz Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ky Pharmacy
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• Mabel Kyinn
• Kykonnect LLC
• Shannon Marie Kyle
• Andrea M Kyro
• Anthony Joseph Kyser
• Heather Elizabeth Kyser, OTR/L
• Samuel Kyser, BCBA
• L. Anthony Sears, D.C., PLLC

• Pediatric Skilled Nursing Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.