Kenneth Lorne Balcombe, M.D.
Individual provider Active NPI Otolaryngology Physician · Louisville, KY
NPI 1720084262 · NPPES record last updated Aug 23, 2012
Key facts
- NPI
- 1720084262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 28985 (KY)
- Practice address
- 6420 Dutchmans Pkwy
Suite 380
Louisville, KY 40205-3372 - Phone
- (502) 894-8441
- Fax
- (502) 894-4453
- NPI assigned
- Jun 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28985 | KY | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medical Associates, Inc. | Past | Accepting new patients | |
| ENT Care Centers PLLC | Otolaryngology | Past |
Accepting new patients |
| Louisville ENT Associates | Otolaryngology | Past | Accepting new patients |
| Advanced ENT and Allergy PLLC | Otolaryngology | Past | Accepting new patients |
| First Urology, PSC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 28985 | KY | Yes |
Addresses
Primary practice location
6420 Dutchmans Pkwy
Suite 380
Louisville, KY 40205-3372
Mailing address
6420 Dutchmans Pkwy
Suite 380
Louisville, KY 40205-3372
Phone (502) 894-8441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64289853 | Medicaid | KY | |
| P00861077 | Other | IN | MEDICARE RAILROAD- ICC |
| 000000674386 | Other | KY | ANTHEM - NICC |
| 117555 | Other | KY | SIHO - NICC |
| 200024650 | Medicaid | IN | |
| 000000045106 | Other | KY | BCBS |
| 610731823 | Other | TAX ID | |
| 61-0719349 | Other | KY | TAX ID |
| 7100199530 | Medicaid | KY | |
| P00861078 | Other | KY | MEDICARE RAILROAD-ICC |
Other providers in Louisville, KY
- Shiva Balasubramanian
- Joselito T Balatbat
- Josue Raul Balbuena
- Stephanie McIntyre Balch
- Dawn Balcom
- Jacob Baldauf
- Takeysha Baldon
- Casey Eugene Baldwin
- Charla Baldwin
- Jill S Baldwin
All providers in Louisville, KY · Otolaryngology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.