Individual provider Active NPI

Marilyn K Wolpert, ARNP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1962438507
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3002139 Issued in KY
Practice address
2360 Stony Brook Dr
Louisville, KY 40220-4018
Phone
(502) 446-5462
Fax
(502) 394-3670
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71001137A IN
Family Nurse Practitioner 363LF0000X 3002139 KY Primary

Addresses

Primary practice location

2360 Stony Brook Dr
Louisville, KY 40220-4018

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 2

IdentifierTypeStateIssuer
200348470MedicaidIN
78005659MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051208000343 KY Practitioner - Nurse Practitioner 7315968120 Reassigns benefits to 2 organizations
I20080122000278 IN Practitioner - Nurse Practitioner 7315968120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001137AINMDFamily Nurse Practitioner
3002139KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family CurrentSince Feb 1, 2019 Accepting new patients
Community Care Health Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Louisville Geriatric Associates Family Past Accepting new patients
Louisville Geriatric Associates Family Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

220 E Lewis and Clark Pkwy
Clarksville, IN 47129
Phone (812) 280-5315

2051 Clevidence Blvd
Ste A
Clarksville, IN 47129
Phone (812) 280-1720

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

2811 Holmans Ln
Jeffersonville, IN 47130
Phone (812) 288-6225

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

2360 Stony Brook Dr
Louisville, KY 40220
Phone (502) 446-5462

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8360/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1962438507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 STONY BROOK DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402204018",
            "telephone_number": "502-446-5462",
            "fax_number": "502-394-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPERT",
        "first_name": "MARILYN",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001137A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200348470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78005659",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.