Louisville Physical Medicine PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

26921 Issued in KY

Legal business name

LOUISVILLE PHYSICAL MEDICINE PLLC

Practice address

3999 Dutchmans LN Ste 4C
Louisville, KY 40207-4745

Phone

(502) 744-3239

NPI assigned

Jan 15, 2018

Organization subpart

No

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

Authorized official

Name

Jane E Weir

Title

Quality Assurance Director

Phone

(205) 694-2020

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17904/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1508374315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 622",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350710622",
            "telephone_number": "205-694-2020",
            "fax_number": "205-380-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN STE 4C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074745",
            "telephone_number": "502-744-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE PHYSICAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WEIR",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "QUALITY ASSURANCE DIRECTOR",
        "authorized_official_telephone_number": "205-694-2020"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "26921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000509322",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50013453",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64269210",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Pathology Associates PSC
• Louisville Patient Centered Medical Home, PSC
• Louisville Pediatric Specialists,PSC
• Louisville Pediatric Therapy Center, Inc.
• Louisville Pediatric Therapy Services
• Louisville Physical Therapy PSC
• Louisville Plastic Surgery Consultants LLC
• Louisville Plastic Surgery Consultants, LLC
• Louisville PM&R PLLC
• Louisville Podiatry PSC

• Physical Medicine & Rehabilitation Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Medicine & Rehabilitation Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.