NPIMap

Organization Active NPI

University Pediatric Pulmonary, LLC

  • Pediatric Pulmonology Physician
  • Louisville, KY
National Provider Identifier
1891026035
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
Legal business name
UNIVERSITY PEDIATRIC PULMONARY, LLC
Practice address
234 E. Gray St.
Ste. 270
Louisville, KY 40202-1903
Phone
(502) 629-8830
Fax
(502) 629-7540
NPI assigned
Jan 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Dr. Gerard P. Rabalais, MDNPI 1437133840
Title
Chairman
Phone
(502) 852-8600

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Pulmonology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0214X Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

234 E. Gray St.
Ste. 270
Louisville, KY 40202-1903

Mailing address

PO Box 2469
Louisville, KY 40201-2469
Phone (502) 852-8500

Other identifiers 3

IdentifierTypeStateIssuer
7100118920MedicaidKY
200998250AMedicaidIN
7100115770MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1891026035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2469",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402012469",
            "telephone_number": "502-852-8500",
            "fax_number": "502-852-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E. GRAY ST.",
            "address_2": "STE. 270",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021903",
            "telephone_number": "502-629-8830",
            "fax_number": "502-629-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRIC PULMONARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "RABALAIS",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "502-852-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100118920",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200998250A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100115770",
            "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 Dec 13, 2010; 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.