LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC (NPI# 1265604763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265604763 |
| Entity Type | Organization |
| Organization Name | LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC |
| Practice Address |
4010 Dupont Cir Suite 308 Louisville KY 40207-4812 |
| Practice Telephone | 5028968041 |
| Practice Fax Number | 5028968044 |
| Mailing Telephone | 5028968041 |
| Mailing Fax Number | 5028968044 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2013-12-27 |
| Authorized Official Name | DR. JAMES D. CHARASIKA (PRESIDENT/CEO) |
| Authorized Official Telephone | 5028968041 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
18988 | KY | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | 18988 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | NPI | 1043299514 | 01 |
| Street Address |
4010 DUPONT CIR SUITE 308 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374452 | Frederick Ray Swain | Dentist | 4010 Dupont Cir, Ste 529, Louisville, KY 40207-4888 | 2005-05-24 |
| 1013402973 | Deshara C Doub | Social Worker | 4010 Dupont Cir, Louisville, KY 40207-4812 | 2018-06-24 |
| 1285145235 | Sandra Kay Decker | Nurse Practitioner | 4010 Dupont Cir, Ste 226, Louisville, KY 40207-4847 | 2017-10-17 |
| 1750830733 | Rebecca J Miller | Counselor | 4010 Dupont Cir, 582, Louisville, KY 40207-4812 | 2016-10-01 |
| 1649631706 | Nicole Elise Robinson | Marriage & Family Therapist | 4010 Dupont Cir, Suite 582, Louisville, KY 40207-4812 | 2016-03-16 |
| 1962861559 | Regina Denice Shelton | Counselor | 4010 Dupont Cir, Suite 379, Louisville, KY 40207-4812 | 2016-02-11 |
| 1679931570 | Michelle Fleming | Social Worker | 4010 Dupont Cir, Suite 379, Louisville, KY 40207-4812 | 2016-02-05 |
| 1275999245 | Leeann Pettis Strobel | Counselor | 4010 Dupont Cir, Suite 226, Louisville, KY 40207-4812 | 2016-01-06 |
| 1295109551 | Ariel Dew | Counselor | 4010 Dupont Cir, Louisville, KY 40207-4812 | 2015-11-23 |
| 1346614849 | Amy Halvorson | Social Worker | 4010 Dupont Cir, Suite 582, Louisville, KY 40207-4812 | 2015-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1619434974 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Centerstone Broadway, 914 East Broadway Suite 200, Louisville, KY 40204 | 2019-02-22 |
| 1558844027 | Arthur James Shulthise Jr. | Family Medicine | Bldg. 2801 - Bowman Field, 2801 Taylorsville Road, Louisville, KY 40205 | 2018-09-11 |
| 1104341171 | Brandy Wells | Family Medicine | 11612 Top Walnut Loop, Louisville, KY 40229 | 2017-08-10 |
| 1437679842 | Michael Edward Lovelace | Family Medicine | 1800 Stevens Avenue, Louisville, KY 40205 | 2017-06-27 |
| 1770939043 | Rss Inc Dba Mediweightloss | Family Medicine | 166 N Hurstbourne Pkwy, Louisville, KY 40222-5108 | 2016-05-05 |
| 1104280379 | Jonathan Paul Newsom | Family Medicine | 2401 Terra Crossing Blvd Ste 101, Louisville, KY 40245-5371 | 2016-04-13 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
Please comment or provide details below to improve the information on LOUISVILLE PATIENT CENTERED MEDICAL HOME, PSC.
| 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.