Active NPI
Mary Tonini
- Family Nurse Practitioner
- Louisville, KY
National Provider Identifier
1467840439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3008576
- Practice address
- 120 Executive Park
Louisville, KY 40207-4201 - Phone
- (502) 855-3919
- NPI assigned
- Dec 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3008576 | KY | Primary |
Addresses
Primary practice location
120 Executive Park
Louisville, KY 40207-4201
Mailing address
120 Executive Park
Louisville, KY 40207-4201
Phone (502) 855-3919
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4813276 | Other | AETNA PIN | |
| 300009618 | Medicaid | IN | |
| 000000993719 | Other | ANTHEM PIN | |
| 7100408830 | Medicaid | KY | |
| CS1809600107 | Other | CARESOURCE ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548806400000",
"number": "1467840439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 EXECUTIVE PARK",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074201",
"telephone_number": "502-855-3919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 EXECUTIVE PARK",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074201",
"telephone_number": "502-855-3919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONINI",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-29",
"last_updated": "2019-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3008576",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "4813276",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300009618",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000993719",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100408830",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE ID",
"identifier": "CS1809600107",
"state": null
}
],
"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 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.