Active NPI
Dedra Hayden, ARNP
- Adult Health Nurse Practitioner
- Louisville, KY
National Provider Identifier
1922333251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 3006183
- Practice address
- 422 Heywood Ave
Louisville, KY 40208-1346 - Phone
- (502) 636-3133
- Fax
- (502) 636-1155
- NPI assigned
- Oct 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 3006183 | KY | Primary |
Addresses
Primary practice location
422 Heywood Ave
Louisville, KY 40208-1346
Mailing address
422 Heywood Ave
Louisville, KY 40208-1346
Phone (502) 636-3133
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3006183 | Other | KY | ARNP-REGISTRATION |
| 6183P | Other | KY | ARNP REGISTRATION |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338508800000",
"number": "1922333251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 HEYWOOD AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402081346",
"telephone_number": "502-636-3133",
"fax_number": "502-636-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 HEYWOOD AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402081346",
"telephone_number": "502-636-3133",
"fax_number": "502-636-1155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYDEN",
"first_name": "DEDRA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-05",
"last_updated": "2012-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "KY",
"license": "3006183",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARNP-REGISTRATION",
"identifier": "3006183",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARNP REGISTRATION",
"identifier": "6183P",
"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 Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.