Commonwealth Family Medicine PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COMMONWEALTH FAMILY MEDICINE PLLC

Practice address

12400 Shelbyville Rd
Louisville, KY 40243-1419

Phone

(502) 883-2218

NPI assigned

Dec 17, 2013

Organization subpart

No

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

Authorized official

Name

Ray Charles Kennedy, MD

Title

Medical Director

Phone

(502) 377-8138

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1902227937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 SHELBYVILLE ROAD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454313",
            "telephone_number": "502-883-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431419",
            "telephone_number": "502-883-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "502-377-8138",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.