Individual provider Active NPI

Stephanie A Poynter, DMD

  • Dentist
  • Louisville, KY
National Provider Identifier
1245236892
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7370 Issued in KY
Practice address
2215 Portland Ave
Louisville, KY 40212-1033
Phone
(502) 774-8631
Fax
(502) 776-8912
NPI assigned
Jun 28, 2005
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7370 KY Primary

Addresses

Primary practice location

2215 Portland Ave
Louisville, KY 40212-1033

Mailing address

2215 Portland Ave
Louisville, KY 40212-1033
Phone (502) 774-8631

Other identifiers 2

IdentifierTypeStateIssuer
15983OtherKYDORAL DENTAL
60001906MedicaidKY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626000444 KY Practitioner - Dentist 0244542082 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. CurrentSince Apr 23, 2024 Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers Inc Past Accepting new patients

Locations

1000 Neighborhood Pl
Fairdale, KY 40118
Phone (502) 361-2381

2215 Portland Ave
Louisville, KY 40212
Phone (502) 774-8631

4100 Taylor Blvd
Louisville, KY 40215
Phone (502) 361-2381

4615 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

712 E Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 568-6972

834 E Broadway
Louisville, KY 40204
Phone (502) 583-1981

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1245236892",
    "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": "502-774-8631",
            "fax_number": "502-776-8912"
        },
        {
            "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",
            "fax_number": "502-776-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYNTER",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "15983",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60001906",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.