Individual provider Active NPI

Kate Lindsey Mortenson, DMD

  • Dentist
  • Louisville, KY
National Provider Identifier
1255958559
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10448 Issued in KY
Practice address
3701 Hopewell Rd
Louisville, KY 40299-5392
Phone
(859) 533-5022
NPI assigned
Jul 2, 2020
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10448 KY Primary

Addresses

Primary practice location

3701 Hopewell Rd
Louisville, KY 40299-5392

Mailing address

3508 Hycliffe Ave
Louisville, KY 40207-3714
Phone (859) 533-5022

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
I20200922000194 KY Order and Referring Only - DentistPractitioner - Dentist 1759709868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10448KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1255958559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 HYCLIFFE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073714",
            "telephone_number": "859-533-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 HOPEWELL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995392",
            "telephone_number": "859-533-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "KATE",
        "middle_name": "LINDSEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.