University Pediatric Pulmonary, LLC

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

Legal business name

UNIVERSITY PEDIATRIC PULMONARY, LLC

Practice address

9700 Park Plaza Ave
Ste 110
Louisville, KY 40241-2286

Phone

(502) 629-8830

Fax

(502) 629-7540

NPI assigned

Feb 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gerard P. Rabalais, MD

Title

Chairman

Phone

(502) 852-8600

Specialties & licenses 3

Addresses

Other identifiers 3

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1649577362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2469",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402012469",
            "telephone_number": "502-852-8500",
            "fax_number": "502-852-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 PARK PLAZA AVE",
            "address_2": "STE 110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412286",
            "telephone_number": "502-629-8830",
            "fax_number": "502-629-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRIC PULMONARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "RABALAIS",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "502-852-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100115770",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710018920",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200998250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University Pediatric Endocrinology, LLC
• University Pediatric Endocrinology, LLC
• University Pediatric Gastroenterology, LLC
• University Pediatric Gastroenterology, LLC
• University Pediatric Hematology/Oncology Specialists, LLC
• University Pediatric Pulmonary, LLC
• University Pediatric Rheumatology of Kentucky LLC
• University Pediatric Surgery Associates, PSC
• University Pediatrics Foundation, Inc.
• University Pediatrics Foundation, Inc.

• Pediatric Pulmonology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Pulmonology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.