Iroquois Medical Center,P.S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34540 Issued in KY

Legal business name

IROQUOIS MEDICAL CENTER,P.S.C.

Practice address

1905 W Hebron LN
Suite 103
Shepherdsville, KY 40165-7465

Phone

(502) 957-7580

Fax

(502) 957-6667

NPI assigned

Aug 13, 2007

Last updated

Jun 30, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

IROQUOIS MEDICAL CENTER, P.S.CAs reported in NPPES

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

Authorized official

Name

Mrs. Neva Allen

Title

Director of Operations

Phone

(502) 366-7720

Specialties & licenses 1

Addresses

Other names 1

• IMC FAMILY MEDICINE Former legal business name

Part of

Ted a Farrar MD Imc

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1164614368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 S 3RD ST",
            "address_2": "100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142615",
            "telephone_number": "502-366-7720",
            "fax_number": "502-366-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W HEBRON LN",
            "address_2": "SUITE 103",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657465",
            "telephone_number": "502-957-7580",
            "fax_number": "502-957-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IROQUOIS MEDICAL CENTER,P.S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IROQUOIS MEDICAL CENTER, P.S.C",
        "enumeration_date": "2007-08-13",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "NEVA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "502-366-7720",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "34540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMC FAMILY MEDICINE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Daniel Scott Huelsman, PHARMD
• Jessica Nicole Huff, APRN
• Brent Michael Hurst, DMD, MBA, MS, MS
• Charlotte Kay Ingwersen, M.D.
• Inspire Physical Therapy
• Antwoine Jackson
• James T Dodge DO LLC (Center for Women's Health ARNP)
• James T Dodge, D.O., LLC (Center for Women's Health)
• Kaelin Jansen, APRN
• Tiffany Jenkins

• Family Medicine Physician in Shepherdsville, KY
• Providers in Shepherdsville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.