Active NPI
Neviana G. Dimova, MD
- General Practice Physician
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 58646
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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 Inc
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
| License | State | Type | Specialty |
|---|---|---|---|
| 58646 | KY | MD | General Practice Physician |
| 21469 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers, Inc. | Current | Accepting new patients | |
| Family Health Centers, Inc. | Current | Accepting new patients | |
| Family Health Centers, Inc. | Current | Accepting new patients | |
| Family Health Centers, Inc. | Current | Accepting new patients | |
| Family Health Centers, Inc. | Current | 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 | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1649732603
-
- General Practice Physician
- Jeffersonville, IN
- NPI 1376095711
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1104879469
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1134172489
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1205689064
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1205889540
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1427574862
-
- Federally Qualified Health Center (FQHC)
- Fairdale, KY
- NPI 1871546119
-
- Physician Assistant
- Louisville, KY
- NPI 1023153350
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1942954441
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1356394670
-
- Federally Qualified Health Center (FQHC)
- Louisville, KY
- NPI 1518963230
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Louisville, KY
- NPI 1114279510
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.