Advanced Diabetes Management PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ADVANCED DIABETES MANAGEMENT PLLC

Practice address

4119 Browns LN
BLDG 2
Louisville, KY 40220-1500

Phone

(800) 294-0807

Fax

(502) 681-9883

NPI assigned

May 27, 2016

Last updated

Mar 6, 2017By 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

Michael Aines, APRN

Title

Owner

Phone

(502) 592-9254

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1689022972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 BROWNS LN",
            "address_2": "BLDG 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201500",
            "telephone_number": "800-294-0807",
            "fax_number": "502-681-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 BROWNS LN",
            "address_2": "BLDG 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201500",
            "telephone_number": "800-294-0807",
            "fax_number": "502-681-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIABETES MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "AINES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-592-9254",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100442930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Louisville, KY
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.