Active NPI
Evangeline Ceridan, ARNP
- Nurse Practitioner
- Louisville, KY
National Provider Identifier
1619933199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3773P
- Practice address
- 315 E Broadway
Louisville, KY 40202-1703 - Phone
- (502) 629-2500
- Fax
- (502) 629-3166
- NPI assigned
- Apr 25, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3773P | KY | Primary |
Addresses
Primary practice location
315 E Broadway
Louisville, KY 40202-1703
Mailing address
315 E Broadway
Louisville, KY 40202-1703
Phone (502) 629-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78008919 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1417902925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619933199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 E BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021703",
"telephone_number": "502-629-2500",
"fax_number": "502-629-3166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 E BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021703",
"telephone_number": "502-629-2500",
"fax_number": "502-629-3166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERIDAN",
"first_name": "EVANGELINE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3773P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78008919",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.