NPIMap

Organization Active NPI

TBD Acquisition, LLC

Doing business as The Brook Hospital Dupont

  • Psychiatric Hospital
  • Louisville, KY
National Provider Identifier
1275953754
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
TBD ACQUISITION, LLC
Doing business as
The Brook Hospital Dupont
Practice address
1405 Browns LN
Louisville, KY 40207-4608
Phone
(502) 896-0495
Fax
(502) 893-8792
NPI assigned
Apr 23, 2014
Last updated
Apr 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Authorized official

Name
Tammy Herrmann
Title
Cfo
Phone
(502) 896-0495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X KY Primary

Addresses

Primary practice location

1405 Browns LN
Louisville, KY 40207-4608

Mailing address

1405 Browns LN
Louisville, KY 40207-4608
Phone (502) 896-0495

Other names 1

  • The Brook Hospital Dupont Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140715001096 KY Part B Supplier - Clinic/Group Practice 7911085006 Receives reassigned benefits from 14 practitioners
Practice locations: Louisville, KY; Radcliff, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
TBD Acquisition LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1407 Browns Ln
Louisville, KY 40207
Phone (502) 896-0495

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1275953754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074608",
            "telephone_number": "502-896-0495",
            "fax_number": "502-893-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074608",
            "telephone_number": "502-896-0495",
            "fax_number": "502-893-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TBD ACQUISITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "HERRMANN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-896-0495"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Brook Hospital Dupont",
            "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 28, 2014; 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.