Louisville Cardiology Medical Group, PSC

Primary specialty

SpecialistTaxonomy code 174400000X

License

KY

Legal business name

LOUISVILLE CARDIOLOGY MEDICAL GROUP, PSC

Practice address

3900 Kresge Way
Suite 60
Louisville, KY 40207-4660

Phone

(502) 893-7710

Fax

(502) 893-1391

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rudolph F. Licandro, M.D.

Title

President

Phone

(502) 893-7710

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1508936261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY",
            "address_2": "SUITE 60",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074660",
            "telephone_number": "502-893-7710",
            "fax_number": "502-893-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY",
            "address_2": "SUITE 60",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074660",
            "telephone_number": "502-893-7710",
            "fax_number": "502-893-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE CARDIOLOGY MEDICAL GROUP, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "LICANDRO",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-893-7710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": "KY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65929820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Louisville, KY
• Providers in Louisville, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.