SHAWNEE CHRISTIAN HEALTHCARE CENTER INC (NPI# 1225333743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225333743 |
| Entity Type | Organization |
| Organization Name | SHAWNEE CHRISTIAN HEALTHCARE CENTER INC |
| Practice Address |
234 Amy Ave Louisville KY 40212-2522 |
| Practice Telephone | 5027780001 |
| Mailing Telephone | 5027780001 |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2016-06-16 |
| Authorized Official Name | DAVID A DAGEFORDE (PRESIDENT) |
| Authorized Official Telephone | 5026456817 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
LAL000152 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100150090 | 05 |
| Street Address |
234 AMY AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40212-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548234685 | Allison Mclane Dezarn | Dentist | 234 Amy Ave, Louisville, KY 40212-2522 | 2006-02-15 |
| 1063979458 | Aiesha N Cole | Registered Nurse | 234 Amy Ave, Louisville, KY 40212-2522 | 2019-02-21 |
| 1164940854 | Laura Ann Galvan | Nurse Practitioner | 234 Amy Ave, Louisville, KY 40212-2522 | 2017-09-01 |
| 1427407071 | Amanda Brooke Albro | Nurse Practitioner | 234 Amy Ave, Louisville, KY 40212-2522 | 2016-06-05 |
| 1184004343 | Kacie N Law | Physician Assistant | 234 Amy Ave, Louisville, KY 40212-2522 | 2015-06-03 |
| 1104160399 | Amy Marie Nolan | Social Worker | 234 Amy Ave, Louisville, KY 40212-2522 | 2012-11-12 |
| 1558671701 | Nicole Marie Delisi | Registered Nurse | 234 Amy Ave, Louisville, KY 40212-2522 | 2010-10-20 |
| 1164754008 | Deborah J Moreau | Nurse Practitioner | 234 Amy Ave, Louisville, KY 40212 | 2010-02-03 |
| 1386870046 | Christopher Lynn Sperry | Family Medicine | 234 Amy Ave, Louisville, KY 40212-2522 | 2009-06-08 |
| 1376708438 | Brent Duncan | Family Medicine | 234 Amy Ave, Louisville, KY 40212-2522 | 2008-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003433111 | Shanita Flanagan | Home Health Aide | 4519 Southwestern Parkway, Louisville, KY 40212 | 2020-07-06 |
| 1184118887 | Denise Goldsmith-kelley | Licensed Practical Nurse | 2611 Northwestern Pkwy, Louisville, KY 40212 | 2018-06-18 |
| 1477605426 | Market St Dental Office Psc | Dentist | 2410 West Market St, Louisville, KY 40212 | 2007-01-18 |
| 1528118601 | Portland Dental Psc | Clinic/Center | 465 North 26th Street, Louisville, KY 40212 | 2007-01-11 |
| 1790393643 | Quality Home Care Services, LLC | In Home Supportive Care | 4519 Southwestern Parkway, Same, Louisville, KY 40212 | 2020-07-16 |
| 1659884872 | New Leaf Clinic | Clinic/Center | 2910 W Jefferson St, Louisville, KY 40212 | 2017-11-09 |
| 1043670391 | Rod Ali Erfani | Dentist | 2215 Portland Ave, Louisville, KY 40212 | 2016-02-29 |
| 1386778710 | Patricia Link Fulkerson | Social Worker | 2215 Portland Ave, Louisville, KY 40212 | 2007-03-15 |
| 1033115878 | Carla Marie Broderick | Nurse Practitioner | 2215 Portland Ave, Louisville, KY 40212 | 2005-06-27 |
| 1629074372 | Ann Christy Elliott-gonzalez | Nurse Practitioner | 2215 Portland Ave, Louisville, KY 40212 | 2005-06-27 |
| Find all providers in zip 40212 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649732603 | Family Health Centers, Inc. | Clinic/Center | 4803 Southside Dr, Louisville, KY 40214-2111 | 2019-04-01 |
| 1578774477 | Family Health Centers, Inc. | Clinic/Center | 4805 Southside Dr, Louisville, KY 40214-2111 | 2007-05-24 |
| 1770680019 | Greater Meridian Health Clinic, Inc. | Clinic/Center | 14130 Highway 15 S Ste D, Louisville, MS 39339-6452 | 2006-09-20 |
| 1780698506 | Park Duvalle Community Health Center, Inc | Clinic/Center | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2006-07-28 |
| 1255354361 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 1015 W Chestnut St, Louisville, KY 40203-2048 | 2006-07-26 |
| 1275151292 | Park Duvalle Community Health Center, Inc | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2020-07-07 |
| 1639727951 | Park Duvalle Community Health Center, Inc | Clinic/Center | 1130 W Chestnut St, Louisville, KY 40203-2047 | 2019-08-29 |
| 1811545403 | Park Duvalle Community Health Center, Inc | Clinic/Center | 5901 Greenwood Rd, Louisville, KY 40258-2409 | 2019-08-28 |
| 1427574862 | Family Health Centers, Inc. | Clinic/Center | 2500 W Market St, Louisville, KY 40212-1541 | 2017-08-17 |
| 1245253160 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2006-07-25 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40212 |
Please comment or provide details below to improve the information on SHAWNEE CHRISTIAN HEALTHCARE CENTER INC.
| 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.