NPIMap

Organization Active NPI

University Children's Kidney Specialists, LLC

  • Pediatric Nephrology Physician
  • Louisville, KY
National Provider Identifier
1477600773
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
Legal business name
UNIVERSITY CHILDREN'S KIDNEY SPECIALISTS, LLC
Practice address
210 E Gray Street
Ste. 1000
Louisville, KY 40202-3906
Phone
(502) 629-3972
Fax
(502) 629-3975
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Authorized official

Name
Dr. Gerard P. Rabalais, M.D.NPI 1437133840
Title
Chairman
Phone
(502) 852-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Pediatric Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0210X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

210 E Gray Street
Ste. 1000
Louisville, KY 40202-3906

Mailing address

P.O. Box 2469
Louisville, KY 40201-2469
Phone (502) 852-8500

Other identifiers 2

IdentifierTypeStateIssuer
200432180MedicaidIN
65939571MedicaidKY

National Provider Directory

National Provider Directory

Locations

210 E Gray St
Ste 1000
Louisville, KY 40202
Phone (502) 629-3972

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1477600773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2469",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402012469",
            "telephone_number": "502-852-8500",
            "fax_number": "502-852-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY STREET",
            "address_2": "STE. 1000",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023906",
            "telephone_number": "502-629-3972",
            "fax_number": "502-629-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CHILDREN'S KIDNEY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "RABALAIS",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "502-852-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200432180",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65939571",
            "state": "KY"
        }
    ],
    "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 May 14, 2012; 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.