Individual provider Active NPI

Lisa L Whitlow, CFA

  • Surgical Technologist
  • Louisville, KY
National Provider Identifier
1538345764
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
SA069 Issued in KY
Practice address
2341 Lime Kiln LN
Louisville, KY 40222-3460
Phone
(502) 899-9979
Fax
(502) 899-9939
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X SA069 KY Primary

Addresses

Primary practice location

2341 Lime Kiln LN
Louisville, KY 40222-3460

Mailing address

2341 Lime Kiln LN
Louisville, KY 40222-3460
Phone (502) 899-9979

Other identifiers 1

IdentifierTypeStateIssuer
000000546306OtherKYANTHEM

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA069KYMDSurgical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1538345764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223460",
            "telephone_number": "502-899-9979",
            "fax_number": "502-899-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223460",
            "telephone_number": "502-899-9979",
            "fax_number": "502-899-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOW",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "CFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "KY",
            "license": "SA069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000546306",
            "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 Jan 17, 2008; 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.