Individual provider Active NPI

Harold Kweku Bedu-Addo

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1922620624
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3016409 Issued in KY
Practice address
1546 Berry Blvd Ste B
Louisville, KY 40215-1955
Phone
(502) 823-2579
NPI assigned
May 15, 2020
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3016409 KY Primary
Registered Nurse 163W00000X 1114681 KY

Addresses

Primary practice location

1546 Berry Blvd Ste B
Louisville, KY 40215-1955

Mailing address

156 Mountain Stone CT
Shepherdsville, KY 40165-7732
Phone (614) 218-2947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913002743 KY Practitioner - Nurse Practitioner 6709282924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

200 Nursing Home LN
Pikeville, KY 41501-6896
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1114681KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina Psychiatric/Mental Health CurrentSince Oct 18, 2021 Accepting new patients
Lifesource of North Carolina Psychiatric/Mental Health CurrentSince Oct 18, 2021 Accepting new patients
Can-Teens Foundation Past Accepting new patients
Great Neighbors Living Past Accepting new patients

Locations

200 Nursing Home Ln
Pikeville, KY 41501
Phone (606) 509-7343

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1922620624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 MOUNTAIN STONE CT",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657732",
            "telephone_number": "614-218-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 BERRY BLVD STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151955",
            "telephone_number": "502-823-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDU-ADDO",
        "first_name": "HAROLD",
        "middle_name": "KWEKU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3016409",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1114681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.