NPIMap

Organization Active NPI

Ten Broeck Dupont Inc

  • Psychiatric Hospital
  • Louisville, KY
National Provider Identifier
1649258781
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
100595 Issued in KY
Legal business name
TEN BROECK DUPONT INC
Practice address
1405 Browns LN
Louisville, KY 40207-4608
Phone
(502) 896-0495
Fax
(502) 893-8792
NPI assigned
Jan 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. John Hollinsworth
Title
Chief Executive Officer
Phone
(502) 896-0495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 100595 KY Primary
Psychiatric Residential Treatment Facility 323P00000X

Addresses

Primary practice location

1405 Browns LN
Louisville, KY 40207-4608

Mailing address

1405 Browns LN
Louisville, KY 40207-4608
Phone (502) 896-0495

Other identifiers 2

IdentifierTypeStateIssuer
45000221MedicaidKY
02000008MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
TBD Acquisition LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1649258781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074608",
            "telephone_number": "502-896-0495",
            "fax_number": "502-893-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074608",
            "telephone_number": "502-896-0495",
            "fax_number": "502-893-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEN BROECK DUPONT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HOLLINSWORTH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "502-896-0495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "KY",
            "license": "100595",
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45000221",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02000008",
            "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 Apr 20, 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.