NPIMap

Organization Active NPI

Omni Resource Services Inc Public Health and Wellness Center

  • Health Service Clinic/Center
  • Louisville, KY
National Provider Identifier
1437969300
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
OMNI RESOURCE SERVICES INC PUBLIC HEALTH AND WELLNESS CENTER
Practice address
2001 W Broadway
Louisville, KY 40203-3595
Phone
(502) 276-1273
NPI assigned
Jan 13, 2025
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Jacqueline Sanders
Title
Credentialing Admin
Phone
(502) 365-3394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

2001 W Broadway
Louisville, KY 40203-3595

Mailing address

2001 W Broadway
Louisville, KY 40203-3595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250331002941 KY Part B Supplier - Clinic/Group Practice 0244753234 Receives reassigned benefits from 9 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

2001 W Broadway
Louisville, KY 40203
Phone (502) 365-4162

2001 W Broadway
Ste 13
Louisville, KY 40203
Phone (502) 276-1273

2001 W Broadway
Ste 4
Louisville, KY 40203

2009 W Broadway
Louisville, KY 40203
Phone (502) 276-1273

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1437969300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033595",
            "telephone_number": "502-276-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI RESOURCE SERVICES INC PUBLIC HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CREDENTIALING ADMIN",
        "authorized_official_telephone_number": "502-365-3394"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 13, 2025; 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.