Individual provider Active NPI

Cheryl A Jarzomkowski, APRN-NP

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1194072371
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3007568 Issued in KY
Practice address
5129 Dixie Hwy Ste 100
Louisville, KY 40216-1727
Phone
(502) 447-3242
Fax
(502) 448-4722
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3007568 KY Primary

Addresses

Primary practice location

5129 Dixie Hwy Ste 100
Louisville, KY 40216-1727

Mailing address

100 E Liberty St
Suite 800
Louisville, KY 40202-1434
Phone (502) 447-3242

Other identifiers 1

IdentifierTypeStateIssuer
P01112330OtherKYMEDICARE RR

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
I20120918000142 KY Practitioner - Nurse Practitioner 5092963017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Pinnacle Inpatient Medical Services, PLLCGroup PAC ID 8426312984, 17 clinicians

Practice addresses (Care Compare)

3909 S Wilson Rd
Radcliff, KY 40160-8944
Phone (270) 351-9444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3007568KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Nurse Practitioner Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Pinnacle Inpatient Medical Services, PLLC Nurse Practitioner CurrentSince Apr 2, 2018 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
Komg-Louisville Region Inc. Nurse Practitioner Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

5129 Dixie Hwy
Ste 100
Louisville, KY 40216
Phone (502) 447-3242

1405 Browns Ln
Louisville, KY 40207
Phone (502) 896-0495

215 Central Ave
Ste 100
Louisville, KY 40208
Phone (502) 588-8720

5129 Dixie Hwy
Louisville, KY 40216
Phone (502) 447-3242

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

3909 S Wilson Rd
Radcliff, KY 40160
Phone (270) 351-8976

Organizations & group practices 6

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": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1194072371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-447-3242",
            "fax_number": "502-448-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 DIXIE HWY STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161727",
            "telephone_number": "502-447-3242",
            "fax_number": "502-448-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARZOMKOWSKI",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01112330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.