Greater Louisville Internal Medicine PSC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GREATER LOUISVILLE INTERNAL MEDICINE PSC

Practice address

9517 US Highway 42
Prospect, KY 40059-9237

Phone

(502) 587-0521

Fax

(502) 587-3901

NPI assigned

Feb 15, 2006

Last updated

Nov 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Salvatore Ciliberti, MDNPI 1770506073

Title

Vice President

Phone

(502) 587-0521

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ciliberti, Wijangco & Bosler, PSC Former legal business name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14845/brand/1/csg/1/fhir/r4

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Salvatore A Ciliberti, M.D.

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1770506073
  Medicare reassignment Care Compare group Authorized official
• Padmapriya Balakrishna, M.D.

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1295709251
  Medicare reassignment Care Compare group
• James William Bosler III, MD

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1932173887
  Medicare reassignment Care Compare group
• Michael Dathan Chesnut, M.D.

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1821127333
  Medicare reassignment Care Compare group
• Gregory John Ciliberti, MD

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1285657585
  Medicare reassignment Care Compare group
• Jeffrey T Omer, MD

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1821062605
  Medicare reassignment Care Compare group
• Harry L Renco, MD

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1124093075
  Medicare reassignment Care Compare group
• Jennifer Lynn Walden-Fain, M.D.

  • Internal Medicine Physician
  • Prospect, KY
  • NPI 1841211174
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1407820533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9517 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599237",
            "telephone_number": "502-587-0521",
            "fax_number": "502-587-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9517 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599237",
            "telephone_number": "502-587-0521",
            "fax_number": "502-587-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LOUISVILLE INTERNAL MEDICINE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "CILIBERTI",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-587-0521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65901316",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ciliberti, Wijangco & Bosler, PSC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Ciliberti, Wijangco & Bosler, PSC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joyce P Glackin-Mann, LCSW, LCADC
• Sher Laree Glaser
• Matthew Gregory Gleis, DMD
• Amy Marie Goldsmith, MA, CCC-SLP
• Laura Goodan-Graham, OT
• Whitney L Greene, DPT
• Christina Pecha Greenhalgh
• Bharti Gupta
• Dzanan Gusic, FNP
• Atteyat Hadizadeh

• Internal Medicine Physician in Prospect, KY
• Providers in Prospect, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.