Louisville Lifestyle Medicine is a medicare enrolled "Nurse Practitioner" provider in Louisville, Kentucky. Their current practice location is
3012 Eastpoint Pkwy, Louisville, Kentucky. You can reach out to their office (for appointments etc.) via phone at
(502) 365-4545.
Louisville Lifestyle Medicine is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Louisville Lifestyle Medicine
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1265723399.
Healthcare Provider's Profile
| Full Name | Louisville Lifestyle Medicine |
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| Type | Facility |
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| Speciality | Nurse Practitioner |
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| Location | 3012 Eastpoint Pkwy, Louisville, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1265723399
- Provider Enumeration Date: 04/24/2011
- Last Update Date: 03/25/2019
Medicare PECOS Information:
- PECOS PAC ID: 3577733518
- Enrollment ID: O20110830000212
Medical Identifiers
Medical identifiers for Louisville Lifestyle Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265723399 | NPI | - | NPPES |
| 7100583490 | Medicaid | KY | |
| 7100574590 | Medicaid | KY | |
| 7100584250 | Medicaid | KY | |
| 7100568740 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | 3004876 (Kentucky) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Louisville Lifestyle Medicine acts as a billing entity for following providers:
| Provider Name | Robert A Hobbs |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1891701835
PECOS PAC ID: 3476558248
Enrollment ID: I20060929000112 |
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| Provider Name | Jinjerita C Lucas |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1659694081
PECOS PAC ID: 6305097668
Enrollment ID: I20130627000854 |
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| Provider Name | Whitney Fallon |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1306380019
PECOS PAC ID: 1759668395
Enrollment ID: I20170508001952 |
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| Provider Name | Justin Rzepka |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1922463108
PECOS PAC ID: 2567891484
Enrollment ID: I20200409001470 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Louisville Lifestyle Medicine is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Louisville Lifestyle Medicine
3012 Eastpoint Pkwy,
Louisville, KY 40223-4185
Ph: (502) 365-4545 | Louisville Lifestyle Medicine
3012 Eastpoint Pkwy,
Louisville, KY 40223-4185
Ph: (502) 365-4545 |
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