Active NPI
Louisville Sleep Disorders Center LLC
- Sleep Disorder Diagnostic Clinic/Center
- Louisville, KY
National Provider Identifier
1659391563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sleep Disorder Diagnostic Clinic/Center
- License
- 730067
- Legal business name
- LOUISVILLE SLEEP DISORDERS CENTER LLC
- Practice address
- 4010 Dupont Cir Ste 122
Louisville, KY 40207-4842 - Phone
- (502) 899-9199
- Fax
- (502) 899-1617
- NPI assigned
- Jul 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa Holmes
- Title
- Administrator
- Phone
- (502) 899-9199
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X | 730067 | KY | Primary |
Addresses
Primary practice location
4010 Dupont Cir Ste 122
Louisville, KY 40207-4842
Mailing address
4010 Dupont Cir Ste 122
Louisville, KY 40207-4842
Phone (502) 899-9199
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5005511 | Other | KY | KY PASSPORT ID NUMBER |
| P00077209 | Other | KY | MEDICARE RR ID NUMBER |
| 65941007 | Medicaid | KY |
Other names 1
- American Sleep Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031203000515 | KY | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 5092610006 | Practice locations: Louisville, KY |
National Provider Directory
National Provider DirectoryLocations
4010 DuPont Cir
Ste 303
Louisville, KY 40207
Phone (502) 251-3600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sleep Medicine (Internal Medicine) Physician
- Louisville, KY
- NPI 1447230651
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727913600000",
"number": "1659391563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 DUPONT CIR STE 122",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074842",
"telephone_number": "502-899-9199",
"fax_number": "502-899-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 DUPONT CIR STE 122",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074842",
"telephone_number": "502-899-9199",
"fax_number": "502-899-1617"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOUISVILLE SLEEP DISORDERS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-21",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A",
"authorized_official_last_name": "HOLMES",
"authorized_official_first_name": "THERESA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "502-899-9199"
},
"taxonomies": [
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": "KY",
"license": "730067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KY PASSPORT ID NUMBER",
"identifier": "5005511",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR ID NUMBER",
"identifier": "P00077209",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65941007",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "American Sleep Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.