Arc Kentucky LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300070 Issued in KY

Legal business name

ARC KENTUCKY LLC

Doing business as

Dupont Surgery Center

Practice address

4004 Dupont Cir
Louisville, KY 40207-4819

Phone

(502) 896-6428

Fax

(502) 895-6787

NPI assigned

Jun 2, 2005

Last updated

Aug 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DUPONT SURGERY CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

Dupont Surgery CenterCCN 18C0001015

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1669474748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 DUPONT CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074819",
            "telephone_number": "502-896-6428",
            "fax_number": "502-895-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 DUPONT CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074819",
            "telephone_number": "502-896-6428",
            "fax_number": "502-895-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARC KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001188",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUPONT SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DUPONT SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Araujo
• Kristy Nicole Arauz, M.D.
• Brianna Rose Arbogast, RN
• Brenn Philip Arbra, CRNA
• Arc Clinical Solutions (Wellness on Wheels)
• Arc of Kentucky, LLC
• Arch to Freedom Recovery Center
• Elizabeth M. Archer-Nanda, ARNP
• Elisa Anne Archer, CRNA
• Johanna Suzanne Archer, M.D.

• Ambulatory Surgical Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.