Individual provider Active NPI

Dane Michael Mendelsohn, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1144925439
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3018920 Issued in KY
Practice address
2105 Crums LN
Louisville, KY 40216-4231
Phone
(502) 589-8600
NPI assigned
Apr 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3018920 KY Primary

Addresses

Primary practice location

2105 Crums LN
Louisville, KY 40216-4231

Mailing address

10401 Linn Station Rd Ste 100
Louisville, KY 40223-3842
Phone (502) 589-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230420002039 KY Practitioner - Nurse Practitioner 8224493564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

2550 Eastpoint Pkwy
Suite 210
Louisville, KY 40223-4128
Phone (502) 975-2960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3018920KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince May 1, 2024 Accepting new patients
Seven Counties Services, Inc. CurrentSince Apr 10, 2023 Accepting new patients

Locations

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

10331 Champion Farms Dr
Louisville, KY 40241
Phone (502) 313-6877

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

2550 Eastpoint Pkwy
Ste 210
Louisville, KY 40223
Phone (502) 750-9384

2105 Crums Ln
Shively, KY 40216
Phone (502) 448-2007

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.danemendelsohn@140097.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1144925439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 LINN STATION RD STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233842",
            "telephone_number": "502-589-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 CRUMS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164231",
            "telephone_number": "502-589-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSOHN",
        "first_name": "DANE",
        "middle_name": "MICHAEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.