Bluegrass Allergy Asthma and Immunology PSC

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

License

34409 Issued in KY

Legal business name

BLUEGRASS ALLERGY ASTHMA AND IMMUNOLOGY PSC

Practice address

11900 Plantside Dr Ste 9
Louisville, KY 40299

Phone

(502) 267-0556

Fax

(502) 267-1715

NPI assigned

Nov 3, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Frank Tolis Simon, MDNPI 1407852221

Title

MD/Owner

Phone

(502) 386-4710

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank Tolis Simon, MD

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1407852221
  Medicare reassignment NPD Authorized official
• Frank Gotham Simon, MD

  • Allergy & Immunology (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1336147065
  NPD (past)

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1669984209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206578",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402506578",
            "telephone_number": "812-218-8926",
            "fax_number": "812-218-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 PLANTSIDE DR STE 9",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40299",
            "telephone_number": "502-267-0556",
            "fax_number": "502-267-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS ALLERGY ASTHMA AND IMMUNOLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "TOLIS",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "502-386-4710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "KY",
            "license": "34409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Lick Recovery
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• Blue Sky Case Management, LLC
• Bluegrass Advanced Mental Health, LLC.
• Bluegrass Allergy and Asthma
• Bluegrass Behavioral Health PSC
• Bluegrass Bone & Joint PLLC
• Bluegrass Cardiology Associates PLLC
• Bluegrass Cardiology Associates PLLC
• Bluegrass Care Management Services

• Allergy & Immunology (Internal Medicine) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Allergy & Immunology (Internal Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.