Louisville-Jefferson County Metro Government

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

251K00004 Issued in KY

Legal business name

LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT

Doing business as

Louisville Metro Depart of Public Health & Wellness-NP South Jefferson

Practice address

1000 Neighborhood PL
Fairdale, KY 40118-9697

Phone

(502) 363-1428

Fax

(502) 363-1463

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Robyn M Dickerson, MSM

Title

Fiscal Manager

Phone

(502) 574-6580

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Louisville Metro Depart of Public Health & Wellness-NP South Jefferson Doing business as

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1316072960",
    "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": "1000 NEIGHBORHOOD PL",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "401189697",
            "telephone_number": "502-363-1428",
            "fax_number": "502-363-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-04-22",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "M",
        "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": "251K00004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT MANAGED CARE NUM",
            "identifier": "1051419",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20056263",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisville Metro Depart of Public Health & Wellness-NP South Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krista R Hefty, LMT
• Intrinzik Health Care Services
• Keyonna Johnson, LCSW
• Mosen Rashid Khani, D.C.
• Shelley Lampe
• Lousville-Jefferson County Metro Government
• Dona J Meers, C.N.P.
• Renu M. Mehta, M.D.
• New Hope Adhc LLC
• Amanda Calloway Phillips, NP

• Public Health or Welfare Agency in Fairdale, KY
• Providers in Fairdale, KY by specialty
• Public Health or Welfare Agency in Kentucky

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.