NPIMap

Organization Active NPI

University of Louisville Physicians, Inc.

Doing business as ULP Pediatric Healthy for Life

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1124375027
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.
Doing business as
ULP Pediatric Healthy for Life
Practice address
601 S Floyd St
Suite 805
Louisville, KY 40202-1835
Phone
(502) 852-7309
Fax
(502) 852-2908
NPI assigned
Aug 9, 2012
Last updated
Aug 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Authorized official

Name
John Elliott
Title
VP of HR
Phone
(502) 588-4206

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

601 S Floyd St
Suite 805
Louisville, KY 40202-1835

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0320

Other names 1

  • ULP Pediatric Healthy for Life Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111017000036 KY Part B Supplier - Clinic/Group Practice 3476725599 Receives reassigned benefits from 2,419 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

529 S Jackson St
#416
Louisville, KY 40202
Phone (502) 852-7093

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1124375027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0320",
            "fax_number": "502-588-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S FLOYD ST",
            "address_2": "SUITE 805",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021835",
            "telephone_number": "502-852-7309",
            "fax_number": "502-852-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP OF HR",
        "authorized_official_telephone_number": "502-588-4206"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ULP Pediatric Healthy for Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.