Louisville Patient Centered Medical Home, PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18988 Issued in KY

Legal business name

LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC

Practice address

4010 Dupont Cir
Suite 308
Louisville, KY 40207-4812

Phone

(502) 896-8041

Fax

(502) 896-8044

NPI assigned

Mar 25, 2008

Last updated

Dec 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James D. Charasika, M.D.NPI 1043299514

Title

President/Ceo

Phone

(502) 896-8041

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James D Charasika, M.D.

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1043299514
  Authorized official Same address or phone
• Dominique Coleman, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1821667262
  NPD
• Jennifer Marie Dawson, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1760854574
  NPD (past)

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1265604763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-896-8041",
            "fax_number": "502-896-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-896-8041",
            "fax_number": "502-896-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "CHARASIKA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "502-896-8041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "18988",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "18988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043299514",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Optometric Centers, III PSC (VisionFirst)
• Louisville Orthopaedic Clinic & Sports Rehabilitation Center PSC
• Louisville Orthopaedic Surgery Center PLLC
• Louisville Palliative Care LLC
• Louisville Pathology Associates PSC
• Louisville Pediatric Specialists,PSC
• Louisville Pediatric Therapy Center, Inc.
• Louisville Pediatric Therapy Services
• Louisville Physical Medicine PLLC
• Louisville Physical Therapy PSC (Louisville Physical Therapy)

• Family Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.