Central Kentucky Mobility of Louisville, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

282426 Issued in KY

Legal business name

CENTRAL KENTUCKY MOBILITY OF LOUISVILLE, LLC

Practice address

11700 Commonwealth Dr Ste 900
Louisville, KY 40299-6357

Phone

(859) 266-9061

Fax

(859) 266-6251

NPI assigned

Feb 14, 2008

Last updated

Dec 6, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRAL KENTUCKY MOBILITY, LLCAs reported in NPPES

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

Authorized official

Name

David Preston

Title

General Manager/Owner

Phone

(859) 225-3624

Specialties & licenses 2

Addresses

Other identifiers 2

Part of

Central Kentucky Mobility

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Central Kentucky Mobility

  • Customized Equipment (DME)
  • Lexington, KY
  • NPI 1831207984
  NPPES parent name

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1730357419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 ENTERPRISE DR STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405101014",
            "telephone_number": "859-225-3624",
            "fax_number": "859-225-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 COMMONWEALTH DR STE 900",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996357",
            "telephone_number": "859-266-9061",
            "fax_number": "859-266-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KENTUCKY MOBILITY OF LOUISVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL KENTUCKY MOBILITY, LLC",
        "enumeration_date": "2008-02-14",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "GENERAL MANAGER/OWNER",
        "authorized_official_telephone_number": "859-225-3624"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "7100125720",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "KY",
            "license": "282426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90005653",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45001658",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Louisville, KY
• Providers in Louisville, KY by specialty
• Customized Equipment (DME) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.