Active NPI
Nephrology Associates of Kentuckiana PSC
- Nurse Practitioner
- Louisville, KY
National Provider Identifier
1164764205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- NEPHROLOGY ASSOCIATES OF KENTUCKIANA PSC
- Practice address
- 6400 Dutchmans Pkwy
Suite 250
Louisville, KY 40205-3340 - Phone
- (502) 587-9660
- Fax
- (502) 540-5615
- NPI assigned
- Mar 26, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Debra Lynn Roos, CPC
- Title
- Billing Department Manager
- Phone
- (502) 587-9660
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
6400 Dutchmans Pkwy
Suite 250
Louisville, KY 40205-3340
Mailing address
6400 Dutchmans Pkwy
Suite 250
Louisville, KY 40205-3340
Phone (502) 587-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100089380 | Medicaid | KY |
National Provider Directory
National Provider Directory- Tax ID family
- Nephrology Associates of Kentuckiana PSC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medical Physician Assistant
- Louisville, KY
- NPI 1326462847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629072000000",
"number": "1164764205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 DUTCHMANS PKWY",
"address_2": "SUITE 250",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402053340",
"telephone_number": "502-587-9660",
"fax_number": "502-540-5615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 DUTCHMANS PKWY",
"address_2": "SUITE 250",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402053340",
"telephone_number": "502-587-9660",
"fax_number": "502-540-5615"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEPHROLOGY ASSOCIATES OF KENTUCKIANA PSC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-26",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A",
"authorized_official_last_name": "ROOS",
"authorized_official_first_name": "DEBRA",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "BILLING DEPARTMENT MANAGER",
"authorized_official_telephone_number": "502-587-9660",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CPC"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100089380",
"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 Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.