Kimberly A. Boland, M.D.
Individual provider Active NPI Pediatrics Physician · Louisville, KY
NPI 1861556375 · NPPES record last updated Oct 12, 2020
Key facts
- NPI
- 1861556375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 31983 (KY)
- Practice address
- 231 East Chestnut Street
Louisville, KY 40202-1821 - Phone
- (502) 629-6000
- Fax
- (502) 852-4989
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040913001025 | KY | Practitioner - Pediatric Medicine | 2567439284 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norton Children'S Medical Group, LLC | Current |
Accepting new patients | |
| University of Louisville Physicians, Inc. | Current |
Accepting new patients | |
| Norton Children'S Medical Group, LLC | Pediatrics | Current |
Accepting new patients |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| University of Louisville Physicians, Inc. | Pediatrics | Current | Accepting new patients |
| University of Louisivlle Physicians | Current |
Accepting new patients | |
| Norton Hospitals, Inc | Past | Accepting new patients |
Locations
7752 Solution Ctr
Chicago, IL 60677
571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700
231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500
601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670
200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000
Interoperability endpoints
- kboland39958@direct.nortonhealthcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 31983 | KY | Yes |
Addresses
Primary practice location
231 East Chestnut Street
Louisville, KY 40202-1821
Mailing address
PO Box 909
Louisville, KY 40201-0909
Phone (502) 629-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64319833 | Medicaid | KY | |
| 200180500 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kboland39958@direct.nortonhealthcare.org | Direct | |
| Direct Messaging Address | kboland39958@direct.nortonhealthcare.org | ||
| FHIR URL | https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/ |
Other providers in Louisville, KY
- Omar Bojang
- Kimberly Epperson Bokeno
- Bokhari & Bokhari, PLLC.
- Satheesh Kumar Bokka
- Erika K Boland
- Myrna Lee Boland
- Urban Richard Boland Jr.
- Shaina Danielle Bolden
- Faith Marie Boles
- Mary Maiio Bolgan
All providers in Louisville, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.