University Pediatric Endocrinology, LLC

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

Legal business name

UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC

Practice address

811 E Parrish Ave
Ste 120
Owensboro, KY 42303-3258

Phone

(502) 629-8821

Fax

(502) 629-8824

NPI assigned

Mar 17, 2011

Last updated

Mar 17, 2011By 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

Dr. Gerard P Rabalais, MD

Title

Chairman

Phone

(502) 852-8600

Specialties & licenses 5

Addresses

Other identifiers 2

Tax ID family

University Pediatric Endocrinology LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• University Pediatric Endocrinology, LLC

  • Pediatric Endocrinology Physician
  • Bowling Green, KY
  • NPI 1013216936
  NPD tax ID
• University Pediatric Endocrinology, LLC

  • Pediatric Endocrinology Physician
  • Louisville, KY
  • NPI 1740518463
  NPD tax ID

Locations

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1780983692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2469",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402012469",
            "telephone_number": "502-852-8500",
            "fax_number": "502-852-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E PARRISH AVE",
            "address_2": "STE 120",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033258",
            "telephone_number": "502-629-8821",
            "fax_number": "502-629-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "RABALAIS",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "502-852-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100010410",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200889620",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly R Tyler, D.P.T.
• Terry Whitmer Tyler, M.D.
• Kutluay Uluc, M.D.
• Unbridled Community Health and Rehab
• University of Louisville Research Foundation (Neonatal Follow Up Program)
• University Pediatric Gastroenterology, LLC
• Lindie Lee Unsel, ARNP
• Unwind Brent Rice Counseling LLC
• Christina Bozarth Upleger, PT
• Troy Upleger, PT, DPT

• Pediatric Endocrinology Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Pediatric Endocrinology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.