SOURCE DIAGNOSTICS OF KENTUCKY, LLC (NPI# 1629339171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629339171 |
| Entity Type | Organization |
| Organization Name | SOURCE DIAGNOSTICS OF KENTUCKY, LLC |
| Practice Address |
534 Enterprise Dr Erlanger KY 41017-1526 |
| Mailing Address |
5275 Naiman Pkwy Ste E Solon OH 44139-1029 |
| Practice Telephone | 8665121515 |
| Mailing Telephone | 4406457822 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |
| Authorized Official Name | KATHLEEN A BARRY (COO) |
| Authorized Official Telephone | 4406457822 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Street Address |
534 ENTERPRISE DR |
| City | ERLANGER |
| State | KY |
| Zip Code | 41017-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285932905 | Source Diagnosticsof Kentucky, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 534 Enterprise Dr, Erlanger, KY 41017-1526 | 2011-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053642314 | Fast Response Portable Imaging Inc | Clinic/Center | 4658 Litwin St # A, Fort Campbell, KY 42223 | 2010-01-26 |
| 1689809816 | Heartcare,llc | Clinic/Center | 2001 Button Ln, Suite E, La Grange, KY 40031-7795 | 2009-05-18 |
| 1609061639 | 1003 Investments, LLC | Clinic/Center | 4500 Bowling Blvd, Suite 100, Louisville, KY 40207-5147 | 2007-09-12 |
| 1336289107 | Midwest Radiology Kentucky LLC | Clinic/Center | 4500 Bowling Blvd Ste 100, Louisville, KY 40207-5147 | 2007-02-08 |
| 1972551075 | Soundtech, Inc. | Clinic/Center | 805 E Alexa Dr, Mt Sterling, KY 40353-1000 | 2006-05-04 |
| 1346865763 | Pdi Health Ky LLC | Clinic/Center | 9850 Von Allmen Ct, Louisville, KY 40241-2854 | 2020-06-11 |
| 1801251475 | Kentucky Technical Services, Psc | Clinic/Center | 3945 Peppertree Dr, Lexington, KY 40513-1398 | 2015-12-23 |
| 1467892190 | Alliance Healthcare Services Inc | Clinic/Center | 1000 Saint Christopher Dr, Ashland, KY 41101-7034 | 2013-06-26 |
| 1700831559 | Diagnostic Radiology Systems Inc | Clinic/Center | 3475 Richmond Rd, Suite 150, Lexington, KY 40509-2500 | 2006-05-23 |
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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.