UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC (NPI# 1417083437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417083437 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC |
| Practice Address |
210 E Gray St Ste 803 Louisville KY 40202-3904 |
| Mailing Address |
Po Box 2469 Louisville KY 40201-2469 |
| Practice Telephone | 5026298821 |
| Practice Fax Number | 5026298824 |
| Mailing Telephone | 5028528500 |
| Mailing Fax Number | 5028528556 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2010-12-29 |
| Authorized Official Name | DR. GERARD P RABALAIS (PRESIDENT) |
| Authorized Official Telephone | 5028528560 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100010410 | 05 | |
| IN | 200889620A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013216936 | University Pediatric Endocrinology, LLC | Pediatrics | 720 2nd St, Ste 102, Bowling Green, KY 42101-1778 | 2011-03-17 |
| 1780983692 | University Pediatric Endocrinology, LLC | Dietitian, Registered | 811 E Parrish Ave, Ste 120, Owensboro, KY 42303-3258 | 2011-03-17 |
| 1740518463 | University Pediatric Endocrinology, LLC | Dietitian, Registered | 9700 Park Plaza Avenue, Suite 110, Louisville, KY 40241-2286 | 2009-11-19 |
| Street Address |
210 E GRAY ST STE 803 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-3904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588519 | Salvatore J. Bertolone Jr. | Pediatrics | 210 E Gray St, Ste 601, Louisville, KY 40202-3902 | 2005-06-17 |
| 1699299669 | Nicholas Andrew Beckham | Physical Therapist | 210 E Gray St, Louisville, KY 40202-3900 | 2017-08-01 |
| 1366981532 | Catharine Deeds | Registered Nurse | 210 E Gray St, Suite 900, Louisville, KY 40202-3900 | 2017-02-21 |
| 1417495334 | Angela Goldring | Nurse Practitioner | 210 E Gray St, Suite 700, Louisville, KY 40202-3900 | 2017-02-11 |
| 1265887269 | Brittany Jean Michele Kurtz | Nurse Practitioner | 210 E Gray St, Ste 1000, Louisville, KY 40202-3906 | 2016-04-27 |
| 1164887576 | Stephanie Schell | Nurse Practitioner | 210 E Gray St, Suite 1003, Louisville, KY 40202 | 2015-12-30 |
| 1144697863 | Jennifer Dupree | Nurse Practitioner | 210 E Gray St, Suite 900, Louisville, KY 40202-3900 | 2015-08-28 |
| 1962888941 | Spencer Moorman | Social Worker | 210 E Gray St, Suite 601, Louisville, KY 40202-3902 | 2015-08-03 |
| 1093105306 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 601a, Louisville, KY 40202-3900 | 2015-01-26 |
| 1538559844 | University of Louisville Research Foundation | Physician Assistant | 210 E Gray St, Suite 601a, Louisville, KY 40202-3900 | 2015-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 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 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1780737510 | Susan Raghavan | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2007-01-18 |
| 1659807881 | University of Louisville | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1835 | 2017-05-09 |
| 1093105306 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 601a, Louisville, KY 40202-3900 | 2015-01-26 |
| 1679985519 | Paul Hiers | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2014-05-27 |
| 1386070019 | Susan Raghavan, Md | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2013-09-26 |
| 1144586876 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 803, Louisville, KY 40202-3900 | 2012-04-06 |
| 1447530910 | Priyanka Bakhtiani | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1837 | 2011-08-27 |
| 1669765749 | Bradly Jackson Thrasher | Pediatrics | 411 E Chestnut St # St7, Louisville, KY 40202-1713 | 2011-05-23 |
| 1124159009 | Kupper Anthony Wintergerst | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811121692 | Evangelia Kalaitzoglou | Pediatrics | 2195 Harrodsburg Rd Ste 125, Lexington, KY 40504 | 2009-05-08 |
| 1023162492 | Wilburn Jackson Smith IIi | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2007-01-23 |
| 1326113234 | John Fowlkes | Pediatrics | 800 Rose St, Lexington, KY 40536-0001 | 2006-11-24 |
| 1346330909 | Alba E. Morales Pozzo | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1255421814 | Kathryn Thrailkill | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1568482826 | Charles Charlton Mabry | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2006-07-20 |
| City | LOUISVILLE |
| Zip Code | 40202 |
Please comment or provide details below to improve the information on UNIVERSITY PEDIATRIC ENDOCRINOLOGY, LLC.
| 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.