Alicia Jeanne Waldrab, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3017979 Issued in KY

Practice address

2215 Portland Ave
Louisville, KY 40212-1033

Phone

(502) 774-8631

NPI assigned

Apr 13, 2019

Last updated

Jun 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, KY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alicia.waldrab@fhci.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/21036/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1649732603
  Medicare reassignment NPD
• Family Care Centers Inc.

  dba Lehigh Valley Physician Group - Pocono

  • Internal Medicine Physician
  • E Stroudsburg, PA
  • NPI 1669563037
  Medicare reassignment NPD
• Neighborhood Health Centers of the Lehigh Valley

  • Federally Qualified Health Center (FQHC)
  • Allentown, PA
  • NPI 1619106382
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1104879469
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1134172489
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205689064
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205889540
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fairdale, KY
  • NPI 1871546119
  NPD
• Family Care Centers Inc

  dba LVPG ExpressCare Pocono

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1316409626
  NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1205399482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121033",
            "telephone_number": "502-953-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121033",
            "telephone_number": "502-774-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRAB",
        "first_name": "ALICIA",
        "middle_name": "JEANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-13",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey R Walden, APRN
• Mark A Waldman, MD
• Shelley C Waldman, APRN
• Stuart Allan Waldman, RPH
• Shreeta Marie Joye Waldon, LCADC
• Amy Waldridge
• Kristin Waldron, PTA
• Lisa Danielle Waldrop, PT, DPT
• Darryl D Wales, CADC
• Brittany Ellyce Waletich, CRC

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.