NPIMap

Organization Active NPI

Dreams With Wings, Inc

  • Behavior Analyst
  • Louisville, KY
National Provider Identifier
1164638516
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DREAMS WITH WINGS, INC
Practice address
2106 Bardstown Rd
Louisville, KY 40205-1916
Phone
(502) 459-4647
Fax
(502) 456-5705
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Authorized official

Name
Jenifer C Frommeyer
Title
Executive Director
Phone
(502) 459-4647

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X KY
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

2106 Bardstown Rd
Louisville, KY 40205-1916

Mailing address

1579 Bardstown Rd
Louisville, KY 40205-1150
Phone (502) 459-4647

Other identifiers 4

IdentifierTypeStateIssuer
7100351020MedicaidKY
7100350130MedicaidKY
7100352090MedicaidKY
33000068MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171002001378 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0446525471 Receives reassigned benefits from 4 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

1579 Bardstown Rd
Louisville, KY 40205
Phone (502) 459-4647

2106 Bardstown Rd
Louisville, KY 40205
Phone (502) 459-4647

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1164638516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051150",
            "telephone_number": "502-459-4647",
            "fax_number": "502-456-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051916",
            "telephone_number": "502-459-4647",
            "fax_number": "502-456-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMS WITH WINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "FROMMEYER",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "502-459-4647"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100351020",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100350130",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100352090",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33000068",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 9, 2022; 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.