East Louisville Neurology, PSC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

32411 Issued in KY

Legal business name

EAST LOUISVILLE NEUROLOGY, PSC

Practice address

13806 Lake Point Circle
Suite 101
Louisville, KY 40223

Phone

(502) 254-4014

Fax

(502) 254-4015

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Juanita Blakeman

Title

Billing Manager

Phone

(502) 254-4014

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1568622314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23568",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-245-4014",
            "fax_number": "502-245-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13806 LAKE POINT CIRCLE",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-254-4014",
            "fax_number": "502-254-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LOUISVILLE NEUROLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "BLAKEMAN",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "502-254-4014"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "2084N0400X",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "32411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64324114",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Louisville Dental Group
• East Louisville Dermatology, PSC
• East Louisville Inpatient Medicine, PLLC
• East Louisville Interventional Pain Specialists PLLC
• East Louisville Interventional Pain Specialists, PLLC
• East Louisville Oral Surgery and Dental Implants PLC
• East Louisville Oral Surgery and Dental Implants PLC
• East Louisville Pathologists PSC
• East Louisville Pediatrics, P.S.C.
• East Louisville Speech Therapy, LLC

• Neurology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neurology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.