NPIMap

Individual provider Active NPI

Julia L Staib, APRN - NP

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1790143295
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3009758 Issued in KY
Practice address
4402 Churchman Ave
Suite 300
Louisville, KY 40215-1190
Phone
(502) 363-0588
Fax
(502) 363-0972
NPI assigned
Jan 29, 2016
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3009758 KY Primary

Addresses

Primary practice location

4402 Churchman Ave
Suite 300
Louisville, KY 40215-1190

Mailing address

100 E Liberty St
Suite 800
Louisville, KY 40202-1434
Phone (502) 363-0588

Other identifiers 1

IdentifierTypeStateIssuer
7100395440MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229000039 KY Practitioner - Nurse Practitioner 5395040414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

201 Abraham Flexner Way
Suite 1200
Louisville, KY 40202-3481
Phone (502) 583-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3009758KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Nurse Practitioner CurrentSince Nov 1, 2019 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

4402 Churchman Ave
Ste 300
Louisville, KY 40215
Phone (502) 363-0588

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Interoperability endpoints

  • Direct secure messaging: jstaib14032@uoflhealth-dm.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1790143295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-363-0588",
            "fax_number": "502-363-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151190",
            "telephone_number": "502-363-0588",
            "fax_number": "502-363-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAIB",
        "first_name": "JULIA",
        "middle_name": "L",
        "credential": "APRN - NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3009758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100395440",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.