COMMUNITY CARE OF KENTUCKY, INC. (NPI# 1215327994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215327994 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF KENTUCKY, INC. |
| Practice Address |
3438 Taylor Blvd Louisville KY 40215-2648 |
| Practice Telephone | 5023664442 |
| Practice Fax Number | 5023664446 |
| Mailing Telephone | 5023664442 |
| Mailing Fax Number | 5023664446 |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2016-02-04 |
| Authorized Official Name | TODD CRUSE (PRESIDENT) |
| Authorized Official Telephone | 6299995006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100348540 | 05 | |
| KY | PASSPORT KY | 50086402 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811375785 | Community Care of Kentucky, Inc. | Dentist | 2500 W Broadway Ste 100, Louisville, KY 40211-1184 | 2015-05-12 |
| 1588056519 | Community Care of Kentucky, Inc. | Dentist | 200 Clinic Dr, Madisonville, KY 42431-1661 | 2015-02-27 |
| Street Address |
3438 TAYLOR BLVD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40215-2648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386749703 | Melanie Renee Abrams | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2006-09-13 |
| 1679051809 | Brooke Elizabeth Shelton | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2018-07-31 |
| 1235580937 | John Quinn Martino | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2016-06-24 |
| 1205219318 | Eom Ji Lee | Dentist | 3438 Taylor Blvd, Louisville, KY 40215 | 2015-07-07 |
| 1194103127 | Community Care of Kentucky, Inc | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2015-05-11 |
| 1851779888 | Community Care of Kentucky, Inc | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2015-05-11 |
| 1407260052 | Community Care of Kentucky Inc. | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2014-06-11 |
| 1881014850 | Kacie Bowles Sharpe | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2014-04-17 |
| 1144537424 | Vitalia I Kadylak | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2010-09-08 |
| 1720308828 | Rohini Ketan Shah | Dentist | 3438 Taylor Blvd, Louisville, KY 40215-2648 | 2010-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417473315 | Robin Jones | Behavioral Analyst | 800 W. Woodlawn Ave, Louisville, KY 40215 | 2017-08-22 |
| 1316332448 | Christopher Fenzel | Emergency Medicine | 1850 Bluegrass Avenue, Louisville, KY 40215 | 2015-04-06 |
| 1447661210 | Khac Phuong Vu | Dentist | 3448 Taylor Boulevard, Louisville, KY 40215 | 2014-05-15 |
| 1619251238 | Scott H Kaminsky | Marriage & Family Therapist | 3535 Taylor Blvd, Louisville, KY 40215 | 2011-09-30 |
| 1821313529 | Taylor Blvd Chiropractic | Chiropractor | 3254 Taylor Blvd, Louisville, KY 40215 | 2010-04-06 |
| 1396985131 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4419 Lasalle Ave, Louisville, KY 40215 | 2009-03-05 |
| 1841448735 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4418 Malcolm Ave., Louisville, KY 40215 | 2008-09-04 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1801911680 | Timothy John Lutes | Dentist | 3205 Taylor Blvd, Louisville, KY 40215 | 2007-03-20 |
| 1063557346 | Louisville-jefferson County Metro Government | Public Health or Welfare | 4255 Hazelwood Avenue, Louisville, KY 40215 | 2007-02-21 |
| Find all providers in zip 40215 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1902292857 | Hayley Redmond | Pediatrics | 571 S Floyd St Ste 332, Louisville, KY 40202 | 2015-04-07 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1114332236 | Amanda Brian Rogers | Pediatrics | 411 E Chestnut St # Street6, Louisville, KY 40202-1713 | 2014-06-26 |
| 1770900144 | Kathryn Thorne | Pediatrics | 9710 Park Plaza Ave Unit 107, Louisville, KY 40241-2292 | 2014-03-24 |
| 1669717690 | Surjeet Singh Dhanjal | Pediatrics | 1506 Thackeray Dr, Louisville, KY 40205-2410 | 2012-12-03 |
| 1164656443 | Betty Sue Spivack | Pediatrics | 8804 Nottingham Pkwy, Louisville, KY 40222-5217 | 2009-05-14 |
| 1821238528 | James Grant Mumford | Pediatrics | 5100 Commerce Crossings Dr, Louisville, KY 40229-2128 | 2009-02-20 |
| 1033371216 | Jonathan R Malowitz | Pediatrics | 4123 Dutchmans Lane Suite 301, Suburban Medical Plaza 3, Louisville, KY 40207 | 2008-06-27 |
| 1356509954 | Julia Lane Mitchell | Pediatrics | 760 S. Hancock St, B100, Louisville, KY 40203 | 2008-05-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40215 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.