Partners in Palliative Care PLLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

41139 Issued in KY

Legal business name

PARTNERS IN PALLIATIVE CARE PLLC

Practice address

7504 Westport Rd
Louisville, KY 40222-4108

Phone

(502) 693-2681

Fax

(502) 495-9738

NPI assigned

Oct 1, 2009

Last updated

Dec 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Staci A Mandrola, MDNPI 1912129552

Title

Sole Member

Phone

(502) 693-2681

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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.

• Staci A Mandrola, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1912129552
  Authorized official Same address or phone

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1134453582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5672 RELIABLE PARKWAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860056",
            "telephone_number": "502-637-4579",
            "fax_number": "502-813-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 WESTPORT RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224108",
            "telephone_number": "502-693-2681",
            "fax_number": "502-495-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN PALLIATIVE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "MANDROLA",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "502-693-2681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "KY",
            "license": "41139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000625202",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3756447000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50026941",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100105330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.