Active NPI
Tiffany Ramirez-Icaza, APRN
- Nurse Practitioner
- Louisville, KY
National Provider Identifier
1801294731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3008983
- Practice address
- 716 W Broadway
Louisville, KY 40202-2216 - Phone
- (502) 595-7744
- NPI assigned
- Dec 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3008983 | KY | Primary |
Addresses
Primary practice location
716 W Broadway
Louisville, KY 40202-2216
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3008983 | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidney Care Consultants, PSC | Nurse Practitioner | Current | Accepting new patients |
Locations
716 W Broadway
Louisville, KY 40202
Phone (502) 222-3449
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1801294731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776351",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776351",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 W BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402022216",
"telephone_number": "502-595-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMIREZ-ICAZA",
"first_name": "TIFFANY",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-09",
"last_updated": "2021-05-24",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3008983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.