Individual provider Active NPI

Jody Fonseca

  • Licensed Practical Nurse
  • Louisville, KY
National Provider Identifier
1891005955
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2032302 Issued in KY
Practice address
708 Magazine St
Louisville, KY 40203-2043
Phone
(502) 589-6000
Fax
(502) 589-8771
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2032302 KY Primary

Addresses

Primary practice location

708 Magazine St
Louisville, KY 40203-2043

Mailing address

101 W. Muhammad Ali Blvd
Louisville, KY 40202-1451
Phone (502) 589-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2032302KYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1891005955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W. MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021451",
            "telephone_number": "502-589-6000",
            "fax_number": "502-589-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 MAGAZINE ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032043",
            "telephone_number": "502-589-6000",
            "fax_number": "502-589-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "JODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KY",
            "license": "2032302",
            "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 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.