NPIMap

Organization Active NPI

Louisville Lung Care PLLC

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1841564291
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
42043 Issued in KY
Legal business name
LOUISVILLE LUNG CARE PLLC
Practice address
1015 Dupont Rd
Louisville, KY 40207-4610
Phone
(502) 883-0227
Fax
(502) 410-0484
NPI assigned
Mar 2, 2012
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Moutaz Al-Nabhan, MDNPI 1205853900
Title
Sole MBR
Phone
(918) 691-2223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU
Acute Care Nurse Practitioner 363LA2100X 42043 KY Primary

Addresses

Primary practice location

1015 Dupont Rd
Louisville, KY 40207-4610

Mailing address

PO Box 22225
Louisville, KY 40252-0225
Phone (918) 691-2223

Other identifiers 1

IdentifierTypeStateIssuer
7100142140MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120802000215 KY Part B Supplier - Clinic/Group Practice 5496910143 Receives reassigned benefits from 8 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1841564291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22225",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402520225",
            "telephone_number": "918-691-2223",
            "fax_number": "502-410-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DUPONT RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074610",
            "telephone_number": "502-883-0227",
            "fax_number": "502-410-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE LUNG CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "AL-NABHAN",
        "authorized_official_first_name": "MOUTAZ",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "918-691-2223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "42043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100142140",
            "state": "KY"
        }
    ],
    "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 Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.