Individual provider Active NPI

Neviana G. Dimova, MD

  • General Practice Physician
  • Louisville, KY
National Provider Identifier
1558929893
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
58646 Issued in KY
Practice address
4100 Taylor Blvd
Louisville, KY 40215-2342
Phone
(502) 953-4700
Fax
(502) 772-8189
NPI assigned
Jun 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21469 PR
General Practice Physician 208D00000X ACN1440 FL
Student in an Organized Health Care Education/Training Program 390200000X 14862 PR
General Practice Physician 208D00000X 58646 KY Primary

Addresses

Primary practice location

4100 Taylor Blvd
Louisville, KY 40215-2342

Mailing address

PO Box 950244
Louisville, KY 40295-0244
Phone (502) 953-4700

Other practice location 1

921 NE 13th street
Primary care/Ambulatory office
Oklahoma, OK 73104
Phone (404) 456-5122

Other practice location 2

1724 E Hallandale Beach Blvd Ste 2A
Hallandale Beach, FL 33009-4611
Phone (954) 456-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220228002106 IN Practitioner - General Practice 5294164638 Reassigns benefits to 1 organization
I20240221002567 KY Practitioner - General Practice 5294164638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers IncGroup PAC ID 6901700053, shared by 11 NPIs, 51 clinicians

Practice addresses (Care Compare)

4100 Taylor Blvd
Louisville, KY 40215-2342
Phone (502) 361-2381

4112 Taylor Blvd
Louisville, KY 40215-2342
Phone (502) 366-4747

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58646KYMDGeneral Practice Physician
21469PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. CurrentSince Jan 7, 2024 Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. CurrentSince Jan 7, 2024 Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Robert B. Nolan, Jr., MD, PLLC Current Accepting new patients
North Clark Medical Group LLC General Practice CurrentSince Mar 1, 2022 Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers Inc Past Accepting new patients

Locations

2100 Market St
Ste 101
Charlestown, IN 47111
Phone (812) 503-5100

1802 E 10th St
Jeffersonvlle, IN 47130
Phone (502) 893-7744

1804 E 10th St
Jeffersonvlle, IN 47130
Phone (502) 553-0810

1000 Neighborhood Pl
Fairdale, KY 40118
Phone (502) 361-2381

712 E Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 568-6972

4805 Southside Dr
Louisville, KY 40214
Phone (502) 772-8860

120 W Broadway
Louisville, KY 40202
Phone (502) 772-8662

4803 Southside Dr
Louisville, KY 40214
Phone (502) 363-8606

2215 Portland Ave
Louisville, KY 40212
Phone (502) 774-8631

4615 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

834 E Broadway
Louisville, KY 40204
Phone (502) 583-1981

2500 W Market St
Louisville, KY 40212
Phone (502) 778-0084

4112 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

4100 Taylor Blvd
Louisville, KY 40215
Phone (502) 361-2381

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1558929893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950244",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950244",
            "telephone_number": "502-953-4700",
            "fax_number": "502-772-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 TAYLOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152342",
            "telephone_number": "502-953-4700",
            "fax_number": "502-772-8189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 NE 13th street",
            "address_2": "Primary care/Ambulatory office",
            "address_purpose": "LOCATION",
            "city": "Oklahoma",
            "state": "OK",
            "postal_code": "73104",
            "country_code": "US",
            "telephone_number": "404-456-5122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1724 E Hallandale Beach Blvd Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Hallandale Beach",
            "state": "FL",
            "postal_code": "330094611",
            "country_code": "US",
            "telephone_number": "954-456-9696",
            "fax_number": "954-456-9696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMOVA",
        "first_name": "NEVIANA",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21469",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1440",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "14862",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "58646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.