Ethel Darline Luster Caldwell, ARNP
Individual provider Active NPI Family Nurse Practitioner · Taylorsville, KY
NPI 1154375020 · NPPES record last updated Jan 26, 2015
Key facts
- NPI
- 1154375020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3004768 (KY)
- Practice address
- 870 Taylorsville Road
Taylorsville, KY 40071 - Phone
- (502) 477-8888
- Fax
- (502) 477-2300
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060816000286 | KY | Practitioner - Nurse Practitioner | 3476556226 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3004768 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Medical Associates Inc | Current |
Accepting new patients | |
| Baptist Health Medical Group Inc | Current |
Accepting new patients | |
| Baptist Health Medical Group Inc | Past | Accepting new patients | |
| Baptist Medical Associates, Inc. | Past | Accepting new patients |
Locations
13117 Eastpoint Park Blvd
Ste C
Louisville, KY 40223
Phone (502) 254-0907
2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900
3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3004768 | KY | Yes |
Addresses
Primary practice location
870 Taylorsville Road
Taylorsville, KY 40071
Mailing address
PO Box 950248
Louisville, KY 40295-0248
Phone (502) 489-5730
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4768P | Other | KY | ARNP LIC# |
| 000000524808 | Other | KY | ANTHEM |
| 71000363800 | Medicaid | KY |
Other names
- Ethel Darline Luster
Other providers in Taylorsville, KY
- Hollie Krupp
- Larry Fowler Consulting, Inc.
- Debbie Long
- Loving Care Home Health LLP
- LP Taylorsville LLC
- Shawn Phillip Maskalick
- Michele M McCallion-Christner
- Mary S McLaughlin
- Christine Marie Miles
- Amelia Nichols
All providers in Taylorsville, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.