Organization Active NPI

Louisville Sleep Disorders Center LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Louisville, KY
National Provider Identifier
1659391563
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
License
730067 Issued in KY
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

Updated by the provider on Oct 3, 2024

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5005511OtherKYKY PASSPORT ID NUMBER
P00077209OtherKYMEDICARE RR ID NUMBER
65941007MedicaidKY

Other names 1

  • American Sleep Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000515 KY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5092610006 Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.