Organization Active NPI

Louisville-Jefferson County Metro Government

Doing business as Louisville MetroDepart of Public Health & Wellness - Jeff County Lab

  • Public Health or Welfare Agency
  • Louisville, KY
National Provider Identifier
1245365246
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT
Doing business as
Louisville MetroDepart of Public Health & Wellness - Jeff County Lab
Practice address
430 East Gray Street
Louisville, KY 40202
Phone
(502) 574-6540
Fax
(502) 574-6614
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Ms. Robyn Dickerson, MSM
Title
Fiscal Manager
Phone
(502) 574-6580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X KY Primary

Addresses

Primary practice location

430 East Gray Street
Louisville, KY 40202

Mailing address

400 E Gray St
P. O. Box 1704
Louisville, KY 40202-1740
Phone (502) 574-6514

Other identifiers 2

IdentifierTypeStateIssuer
37902889MedicaidKY
1060990OtherKYPASSPORT MANAGED CARE NUM

Other names 1

  • Louisville MetroDepart of Public Health & Wellness - Jeff County Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604002137 KY Part B Supplier - Clinic/Group Practice 9537064951 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 43)

10015 Mitchell Hill Rd
Fairdale, KY 40118
Phone (502) 366-0122

514 W Liberty St
Louisville, KY 40202
Phone (502) 574-4260

501 W Ashland Ave
Louisville, KY 40214
Phone (502) 363-9205

4401 Rangeland Rd
Louisville, KY 40219
Phone (502) 962-3174

2600 S 4th St
Louisville, KY 40208
Phone (502) 574-3518

4101 Bardstown Rd
Louisville, KY 40218
Phone (502) 491-0085

3228 River Park Dr
Louisville, KY 40211
Phone (502) 776-9400

4810 Exeter Ave
Louisville, KY 40218
Phone (502) 458-0778

1500 S 6th St
Louisville, KY 40208
Phone (502) 637-9309

1800 Park Rd
Louisville, KY 40216
Phone (502) 449-5025

4535 Manslick Rd
Louisville, KY 40216
Phone (502) 363-9428

706 W Kenwood Dr
Louisville, KY 40214
Phone (502) 363-9563

430 E Gray St
Louisville, KY 40202
Phone (502) 574-6540

834 E Broadway
#5
Louisville, KY 40204

3511 Fincastle Rd
Louisville, KY 40213
Phone (502) 458-9814

1761 Frankfort Ave
Louisville, KY 40206
Phone (502) 896-9170

2600 S 4th St
#8
Louisville, KY 40208
Phone (502) 574-3518

821 S 6th St
Louisville, KY 40203
Phone (502) 574-1553

2620 Frankfort Ave
Louisville, KY 40206
Phone (502) 896-9291

1411 Algonquin Pkwy
Louisville, KY 40210
Phone (502) 634-6077

1735 Bardstown Rd
Louisville, KY 40205
Phone (502) 458-9383

1824 Garland Ave
Louisville, KY 40210
Phone (502) 776-9308

235 E Jefferson St
Louisville, KY 40202
Phone (502) 574-1561

7308 Fegenbush Ln
Louisville, KY 40228
Phone (502) 239-3561

3401 Dutchmans Ln
#10
Louisville, KY 40205
Phone (502) 458-9363

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1245365246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E GRAY ST",
            "address_2": "P. O. BOX 1704",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021740",
            "telephone_number": "502-574-6514",
            "fax_number": "502-574-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 EAST GRAY STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-574-6540",
            "fax_number": "502-574-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-04-22",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "502-574-6580",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSM"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37902889",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT MANAGED CARE NUM",
            "identifier": "1060990",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisville MetroDepart of Public Health & Wellness - Jeff County Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.