Individual provider Active NPI

Ariamna Fleites Gomez

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1386483493
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4021553 Issued in KY
Practice address
1918 Hikes LN Ste 102
Louisville, KY 40218-2598
Phone
(502) 473-4067
Fax
(502) 473-4077
NPI assigned
May 20, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4021553 KY Primary

Addresses

Primary practice location

1918 Hikes LN Ste 102
Louisville, KY 40218-2598

Mailing address

1918 Hikes LN Ste 102
Louisville, KY 40218-2598
Phone (502) 473-4067

Other practice location 1

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone (502) 714-3960

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120002581 KY Practitioner - Nurse Practitioner 9133654619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Ky Holding, LLC Nurse Practitioner CurrentSince Dec 1, 2024 Accepting new patients
PMR Ky Holding, LLC PastSince Nov 24, 2024 Accepting new patients

Locations

1918 Hikes Ln
#102
Louisville, KY 40218
Phone (502) 473-4067

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1386483493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 HIKES LN STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182598",
            "telephone_number": "502-473-4067",
            "fax_number": "502-473-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 HIKES LN STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182598",
            "telephone_number": "502-473-4067",
            "fax_number": "502-473-4077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Bluegrass Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402151161",
            "country_code": "US",
            "telephone_number": "502-714-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEITES GOMEZ",
        "first_name": "ARIAMNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4021553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.