Innovage Kentucky Pace- Louisville, LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

INNOVAGE KENTUCKY PACE- LOUISVILLE, LLC

Practice address

6013 Preston Hwy
Louisville, KY 40219-1317

Phone

(303) 869-4664

NPI assigned

Dec 10, 2021

Organization subpart

No

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

Authorized official

Name

Gayle Washington

Title

Credentialing Director

Phone

(303) 912-7193

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1720747413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 E LOWRY BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307030",
            "telephone_number": "303-912-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6013 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191317",
            "telephone_number": "303-869-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVAGE KENTUCKY PACE- LOUISVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "303-912-7193"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PACE Provider Organization in Louisville, KY
• Providers in Louisville, KY by specialty
• PACE Provider Organization in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.