NPIMap

Organization Active NPI

360Care Services of Kentucky LLC

  • Podiatrist
  • Louisville, KY
National Provider Identifier
1477324150
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
360CARE SERVICES OF KENTUCKY LLC
Practice address
12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone
(248) 528-2116
Fax
(502) 996-8282
NPI assigned
Jan 11, 2024
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Joy L Stevens
Title
Director of Revenue
Phone
(502) 244-2441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404

Mailing address

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 813-4415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220604000305 KY Part B Supplier - Clinic/Group Practice 9931587888 Receives reassigned benefits from 45 practitioners
2 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 2

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

National Provider Directory

National Provider Directory
Tax ID family
360Care Services of Kentucky LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

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": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1477324150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-813-4415",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "248-528-2116",
            "fax_number": "502-996-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360CARE SERVICES OF KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "502-244-2441"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "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 11, 2024; 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.