KENTUCKY MEDICAL SPECIALISTS, PSC (NPI# 1295090884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295090884 |
| Entity Type | Organization |
| Organization Name | KENTUCKY MEDICAL SPECIALISTS, PSC |
| Practice Address |
4001 Kresge Way Ste # 236 Louisville KY 40207 |
| Practice Telephone | 5028937372 |
| Practice Fax Number | 5024094715 |
| Mailing Telephone | 5028937372 |
| Mailing Fax Number | 5024094715 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2019-05-01 |
| Authorized Official Name | MARLON R CHAGUA (PRESIDENT) |
| Authorized Official Telephone | 5028937372 |
| 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 | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | 36325 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64063266 | 05 | |
| KY | 7100235310 | 05 |
| Street Address |
4001 KRESGE WAY STE # 236 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689280216 | Hmps Internal Medicine of West Louisville Pllc | Internal Medicine | 2730 Brownsboro Rd Apt 164, Louisville, KY 40206-1268 | 2020-09-18 |
| 1174085203 | New Hope Recovery LLC | Internal Medicine | 2503 Bush Ridge Dr Ste A, Louisville, KY 40245-5885 | 2019-04-06 |
| 1619452364 | Peak Internal Medicine | Internal Medicine | 400 S Mccaslin Blvd Ste 200, Louisville, CO 80027-9701 | 2018-09-28 |
| 1245729870 | Mark Louis Siefring | Internal Medicine | 842 Parkway Dr, Louisville, KY 40217-2456 | 2018-05-09 |
| 1306341417 | Louisville Primary Care | Internal Medicine | 801 Barret Ave Ste 112, Louisville, KY 40204-1732 | 2018-03-29 |
| 1467966143 | Ray Richard Taylor | Internal Medicine | 1618 Polo Club Ct, Louisville, KY 40245-4482 | 2017-11-17 |
| 1972024768 | Paridhi Mathur | Internal Medicine | 6801 Dixie Hwy Ste 40258, Louisville, KY 40258-3913 | 2017-06-30 |
| 1780115998 | Preston Urgent Care, Inc | Internal Medicine | 4822 Preston Hwy, Louisville, KY 40213-2226 | 2017-03-21 |
| 1255873832 | Belissa Malier Ramos Chaves | Internal Medicine | 550 S Jackson St Bldg A, Louisville, KY 40202-1622 | 2016-11-14 |
| 1326499161 | Cristina Salmon | Internal Medicine | 550 S Jackson St Rm A3r40, Louisville, KY 40202-1622 | 2016-06-23 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.