NPIMap

Organization Active NPI

University of Louisville Research Foundation, Inc.

  • Infectious Disease Physician
  • Louisville, KY
National Provider Identifier
1386835007
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC.
Practice address
550 S Jackson St
Acb 2ND Floor
Louisville, KY 40202-1622
Phone
(502) 561-8844
Fax
(502) 589-5093
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Toni Ganzel, MD
Title
VP of Health Affairs
Phone
(502) 852-5555

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

550 S Jackson St
Acb 2ND Floor
Louisville, KY 40202-1622

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0320

Other identifiers 6

IdentifierTypeStateIssuer
50020689OtherKYPASSPORT HEALTH PLAN
1700115800 (PAS)MedicaidKY
200925390MedicaidIN
522843OtherKYANTHEM
7100083550 (MDS)MedicaidKY
3541914000OtherKYPASSPORT ADVANTAGE

Other names 2

  • ULRF WINGS Clinic Doing business as
  • WINGS Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000087 KY Part B Supplier - Clinic/Group Practice 1153234265 Receives reassigned benefits from 30 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

300 Abraham Flexner Way
Louisville, KY 40202

511 S Floyd St
Ste 213
Louisville, KY 40202
Phone (502) 852-5519

511 S Floyd St
#219
Louisville, KY 40202
Phone (502) 852-1174

517 S Floyd St
100
Louisville, KY 40202
Phone (502) 852-5333

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1386835007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0320",
            "fax_number": "502-217-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST",
            "address_2": "ACB 2ND FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-561-8844",
            "fax_number": "502-589-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "GANZEL",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "VP OF HEALTH AFFAIRS",
        "authorized_official_telephone_number": "502-852-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50020689",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700115800 (PAS)",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200925390",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "522843",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100083550 (MDS)",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3541914000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ULRF WINGS Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WINGS Clinic",
            "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 21, 2021; 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.