NPIMap

Organization Active NPI

University of Louisville Research Foundation, Inc

  • Clinical Medical Laboratory
  • Louisville, KY
National Provider Identifier
1366438707
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
200123 Issued in KY
Legal business name
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
Practice address
511 S. Floyd Street
Room 203
Louisville, KY 40292-0001
Phone
(502) 852-5519
Fax
(502) 852-1171
NPI assigned
Sep 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Authorized official

Name
Dr. Mostafa Fraig, M.D.
Title
Medical Director
Phone
(502) 852-1174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 200123 KY Primary

Addresses

Primary practice location

511 S. Floyd Street
Room 203
Louisville, KY 40292-0001

Mailing address

PO Box 3311
Louisville, KY 40201-3311
Phone (502) 852-1174

Other identifiers 1

IdentifierTypeStateIssuer
4016301OtherKYMEDICARE PTAN

Other names 1

  • Special Procedures Laboratory Doing business as

National Provider Directory

National Provider Directory

Locations

511 S Floyd St
Rm 203
Louisville, KY 40202
Phone (502) 852-5519

Practitioners & affiliated clinicians

Practitioners 6

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": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1366438707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3311",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402013311",
            "telephone_number": "502-852-1174",
            "fax_number": "502-852-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S. FLOYD STREET",
            "address_2": "ROOM 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5519",
            "fax_number": "502-852-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "FRAIG",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "502-852-1174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "200123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4016301",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Special Procedures Laboratory",
            "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 Dec 19, 2012; 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.