MDB Psychiatric Services, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3008816 Issued in KY

Legal business name

MDB PSYCHIATRIC SERVICES, LLC

Practice address

714 Lyndon LN Ste 6
Louisville, KY 40222-4643

Phone

(502) 655-9744

Fax

(502) 653-7428

NPI assigned

Jul 7, 2017

Organization subpart

No

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

Authorized official

Name

Melissa Bishop, APRN, PMHNP-BC

Title

Aprn

Phone

(502) 655-9744

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396267704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 228",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074825",
            "telephone_number": "502-655-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 LYNDON LN STE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224643",
            "telephone_number": "502-655-9744",
            "fax_number": "502-653-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDB PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "502-655-9744",
        "authorized_official_credential": "APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3008816",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.