NPIMap

Organization Active NPI

Clinical Associates, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Louisville, KY
National Provider Identifier
1881697464
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
200291 Issued in KY
Legal business name
CLINICAL ASSOCIATES, LLC
Practice address
2935 Breckenridge LN Ste 101
Louisville, KY 40220-1408
Phone
(502) 897-9594
Fax
(502) 896-1808
NPI assigned
May 27, 2005
Organization subpart
Yes
Parent organization
NORTON ENTERPRISES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Dianne S Rowan
Title
Director Finance Billing
Phone
(502) 897-9594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 200291 KY Primary
Clinical Medical Laboratory 291U00000X 200291 KY

Addresses

Primary practice location

2935 Breckenridge LN Ste 101
Louisville, KY 40220-1408

Mailing address

PO Box 538359
Atlanta, GA 30353-8359
Phone (502) 897-9594

Other identifiers 8

IdentifierTypeStateIssuer
000000061989OtherKYANTHEM WELLPOINT
65908972MedicaidKY
1049047OtherKYPASSPORT KY MEDICAID
020379400OtherKYBLACK LUNG PROGRAM
2432349000OtherKYPASSPORT ADVANTAGE
100009130MedicaidIN
000000058863OtherKYANTHEM - - BLUE CROSS BLUE SHIELD
163387800OtherKYFECA

Other names 1

  • CPA Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060627000058 KY Part B Supplier - Independent Clinical Laboratory 3577456300 Practice locations: Elizabethtown, KY; Louisville, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Clinical Associates LLC2 organizations share this tax ID, including this one
Part of
Advantage One Lab

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1881697464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538359",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538359",
            "telephone_number": "502-897-9594",
            "fax_number": "502-896-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 BRECKENRIDGE LN STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201408",
            "telephone_number": "502-897-9594",
            "fax_number": "502-896-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTON ENTERPRISES INC",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "ROWAN",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR FINANCE BILLING",
        "authorized_official_telephone_number": "502-897-9594"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "200291",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "200291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM WELLPOINT",
            "identifier": "000000061989",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65908972",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT KY MEDICAID",
            "identifier": "1049047",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG PROGRAM",
            "identifier": "020379400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432349000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009130",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - - BLUE CROSS BLUE SHIELD",
            "identifier": "000000058863",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FECA",
            "identifier": "163387800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPA Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CPA Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 23, 2021; 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.