SOUTHSIDE PERSONAL CARE HOME LLC (NPI# 1427671700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427671700 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE PERSONAL CARE HOME LLC |
| Practice Address |
5330 S 3rd St Louisville KY 40214-2680 |
| Practice Telephone | 5025331492 |
| Practice Fax Number | 5022129292 |
| Mailing Telephone | 5025331492 |
| Mailing Fax Number | 5022129292 |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | ABDIRASHID AHMED KANYARE (MANAGER) |
| Authorized Official Telephone | 5025331492 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 374U00000X | Home Health Aide | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | CABINET FOR HEALTH AND FAMILY SERVICES OFFICE OF INSPECTOR GENER | 500334 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740802354 | Southside Personal Care Home LLC | Home Health Aide | 5330 S 3rd St Ste 200, Louisville, KY 40214-2689 | 2020-05-18 |
| Street Address |
5330 S 3RD ST |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40214-2680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477058659 | Abcdentistry | Clinic/Center | 5316 S 3rd St, Louisville, KY 40214 | 2018-03-28 |
| 1538591300 | Byrne Dental,psc | Dentist | 4739 So. Third Street, Louisville, KY 40214 | 2013-08-05 |
| 1205110400 | Michael Wayne Probst | Pharmacist | 5201 South Third Street, Louisville, KY 40214 | 2011-10-06 |
| 1871876920 | Cindy Eillene Ohlmann | Pharmacist | 5400 New Cut Road, Louisville, KY 40214 | 2011-09-26 |
| 1801129960 | Deborah Suzanne Slusher | Speech-Language Pathologist | 109 Seneca Trail, Louisville, KY 40214 | 2009-09-08 |
| 1255592267 | Mitisha Nichole Martin | Dentist | 5316 S. 3rd Street, Louisville, KY 40214 | 2008-06-23 |
| 1588862361 | Kentucky Eye Surgery Associates Psc | Ophthalmology | 4940 Hazelwood Avenue, Louisville, KY 40214 | 2007-07-03 |
| 1558565739 | James Latroy Burks | Counselor | 927 Southview Rd, Louisville, KY 40214 | 2007-06-12 |
| 1770792475 | Kimberly Lynn Wheatley | Physical Therapist | 250 Kenwood Hill Road, Louisville, KY 40214 | 2007-05-21 |
| 1821219601 | Courtney Marie Smith | Speech-Language Pathologist | 3222 Rolling Oak Blvd, Louisville, KS 40214 | 2007-05-01 |
| Find all providers in zip 40214 | ||||
| Taxonomy Code | 374U00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Home Health Aide |
| A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003433111 | Shanita Flanagan | Home Health Aide | 4519 Southwestern Parkway, Louisville, KY 40212 | 2020-07-06 |
| 1740802354 | Southside Personal Care Home LLC | Home Health Aide | 5330 S 3rd St Ste 200, Louisville, KY 40214-2689 | 2020-05-18 |
| 1497382329 | Wesley A Weisel | Home Health Aide | 6291 Joliat Avenue, Louisville, OH 44641 | 2020-03-23 |
| 1912533423 | Pleshette Maypray | Home Health Aide | 10243 Riverstone Cir, Louisville, KY 40229-5228 | 2020-03-16 |
| 1285268060 | Donna Ray Smith | Home Health Aide | 3012 Boaires Ln, Louisville, KY 40220-2428 | 2020-03-02 |
| 1568093854 | Ashley Nicola Pendergrast | Home Health Aide | 7318 Monsey Cir Apt 102, Louisville, KY 40219-8356 | 2020-01-27 |
| 1134766090 | 4urhart, Inc Dba Home Helpers Home Care #58600 | Home Health Aide | 8401 Shelbyville Rd Ste 212, Louisville, KY 40222-5585 | 2019-12-10 |
| 1063935807 | Amanda Nicole Johnson | Home Health Aide | 5831 Ravenna Ave, Louisville, OH 44641-9216 | 2017-07-24 |
| 1508220963 | Sue Mercer | Home Health Aide | 9885 Reeder Ave, Louisville, OH 44641-8507 | 2016-04-11 |
| 1124426275 | Rebecca Sue Jenkins | Home Health Aide | 3523 Whippoorwill Rd, Louisville, KY 40213 | 2014-12-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40214 |
Please comment or provide details below to improve the information on SOUTHSIDE PERSONAL CARE HOME 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.