Individual provider Active NPI

Kimberly Dawn Aulick, PA

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1225085681
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA206 Issued in KY
Practice address
2020 Newburg Rd
Louisville, KY 40205-1803
Phone
(502) 479-4500
Fax
(502) 479-4140
NPI assigned
May 30, 2006
Last updated
Aug 31, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA206 KY Primary

Addresses

Primary practice location

2020 Newburg Rd
Louisville, KY 40205-1803

Mailing address

6801 Dixie Hwy
Suite 130
Louisville, KY 40258-3913
Phone (502) 451-5855

Other identifiers 1

IdentifierTypeStateIssuer
95003315MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA206KYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1225085681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "SUITE 130",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583913",
            "telephone_number": "502-451-5855",
            "fax_number": "502-479-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 NEWBURG RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051803",
            "telephone_number": "502-479-4500",
            "fax_number": "502-479-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULICK",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95003315",
            "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 31, 2007; 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.