| Family Health Centers, Inc. | |
| 
					4803 Southside Dr Louisville KY 40214-2111  | |
| (502) 772-8891 | |
| (502) 996-8309 | 
| Full Name | Family Health Centers, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 4803 Southside Dr, Louisville, Kentucky | 
| Authorized Official Name and Position | Bart Irwin (CEO (INTERIM)) | 
| Authorized Official Contact | 5027748631 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Family Health Centers, Inc. Po Box 950244 Louisville KY 40295-0244 Ph: (502) 953-4799  | Family Health Centers, Inc. 4803 Southside Dr Louisville KY 40214-2111 Ph: (502) 772-8891  | 
| NPI Number | 1649732603 | 
|---|---|
| Provider Enumeration Date | 04/01/2019 | 
| Last Update Date | 07/16/2021 | 
| Medicare PECOS PAC ID | 6901700053 | 
|---|---|
| Medicare Enrollment ID | O20031121000045 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1649732603 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary | 
| Provider Name | Angela R Schardein | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1336250422 PECOS PAC ID: 0143128611 Enrollment ID: I20031222000313  | 
| Provider Name | Tobey L Coyle | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1871599894 PECOS PAC ID: 9436050945 Enrollment ID: I20040117000065  | 
| Provider Name | Natalie Zelichenok | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1043216757 PECOS PAC ID: 6103718192 Enrollment ID: I20040325001120  | 
| Provider Name | Denise L Buskill | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1043240807 PECOS PAC ID: 3375530447 Enrollment ID: I20040429000771  | 
| Provider Name | Dennis Franklin Kinlaw | 
|---|---|
| Provider Type | Practitioner - General Practice | 
| Provider Identifiers | NPI Number: 1619074713 PECOS PAC ID: 0042279143 Enrollment ID: I20041005000793  | 
| Provider Name | Kevin B Spicer | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1902854334 PECOS PAC ID: 5092778498 Enrollment ID: I20041106000201  | 
| Provider Name | Gwendolyn Sue Rinker | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801892500 PECOS PAC ID: 4789633777 Enrollment ID: I20050117000548  | 
| Provider Name | Julia E. Richerson | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1003810920 PECOS PAC ID: 9133037476 Enrollment ID: I20050207000117  | 
| Provider Name | Thomas James | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1942265053 PECOS PAC ID: 5193770063 Enrollment ID: I20050315000020  | 
| Provider Name | Teresa G Casey | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1265411250 PECOS PAC ID: 3870530355 Enrollment ID: I20050415000441  | 
| Provider Name | John H Hines | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1194780171 PECOS PAC ID: 3971574336 Enrollment ID: I20050624000596  | 
| Provider Name | James D Jackson | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1235135039 PECOS PAC ID: 9830135649 Enrollment ID: I20050701000514  | 
| Provider Name | Jeffrey Glazer | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1467415778 PECOS PAC ID: 5092752105 Enrollment ID: I20051101001044  | 
| Provider Name | Michelle Eileen Elisburg | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1679572309 PECOS PAC ID: 9739146622 Enrollment ID: I20051207000639  | 
| Provider Name | Frances E Weinstock | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1295714863 PECOS PAC ID: 5092712109 Enrollment ID: I20061103000028  | 
| Provider Name | Susan Elaine Hagan | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1124139241 PECOS PAC ID: 5395743652 Enrollment ID: I20061121000002  | 
| Provider Name | Carla M Broderick | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1033115878 PECOS PAC ID: 2264534387 Enrollment ID: I20070220000772  | 
| Provider Name | Jahangir Cyrus | 
|---|---|
| Provider Type | Practitioner - Endocrinology | 
| Provider Identifiers | NPI Number: 1558306092 PECOS PAC ID: 1951492107 Enrollment ID: I20070802000382  | 
| Provider Name | Rowena S Aquino | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1265407704 PECOS PAC ID: 4688752124 Enrollment ID: I20080423000546  | 
| Provider Name | Vaughn M Bowen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1588733760 PECOS PAC ID: 6507930427 Enrollment ID: I20080811000214  | 
| Provider Name | Kimberly Ann Anna | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1356347199 PECOS PAC ID: 0547328478 Enrollment ID: I20081022000338  | 
| Provider Name | Radhika Veeramachaneni | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1427054378 PECOS PAC ID: 7719047778 Enrollment ID: I20081120000261  | 
| Provider Name | Frank T Simon | 
|---|---|
| Provider Type | Practitioner - Allergy/immunology | 
| Provider Identifiers | NPI Number: 1407852221 PECOS PAC ID: 9739249590 Enrollment ID: I20081124000426  | 
| Provider Name | James R Martin | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1144226952 PECOS PAC ID: 7214097849 Enrollment ID: I20081126000568  | 
| Provider Name | Ann C Elliott Gonzalez | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1629074372 PECOS PAC ID: 6709947013 Enrollment ID: I20081204000965  | 
| Provider Name | Kimberley Brumleve | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1447256458 PECOS PAC ID: 1254492580 Enrollment ID: I20081205000163  | 
| Provider Name | Amanda C Phillips | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1932308855 PECOS PAC ID: 4587722095 Enrollment ID: I20090114000648  | 
| Provider Name | Anna K Huang | 
|---|---|
| Provider Type | Practitioner - Infectious Disease | 
| Provider Identifiers | NPI Number: 1932199270 PECOS PAC ID: 8224011986 Enrollment ID: I20090316000422  | 
| Provider Name | Susan Michelle Taylor Peters | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1427086370 PECOS PAC ID: 2264421908 Enrollment ID: I20090602000592  | 
| Provider Name | Stephanie M Swincher | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1316275910 PECOS PAC ID: 5092859405 Enrollment ID: I20100224000116  | 
| Provider Name | Carole Ann Buskirk | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1770546822 PECOS PAC ID: 2365578929 Enrollment ID: I20100407000541  | 
| Provider Name | Robert Wojda | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1811058860 PECOS PAC ID: 0143345090 Enrollment ID: I20100915000515  | 
| Provider Name | Larry J. Fineman | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1437114998 PECOS PAC ID: 0749477149 Enrollment ID: I20101210000866  | 
| Provider Name | Andrea M Huey-fahas | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1730469784 PECOS PAC ID: 6901078443 Enrollment ID: I20111005000932  | 
| Provider Name | Shavon T Prentice | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1962782128 PECOS PAC ID: 0446419253 Enrollment ID: I20120323000276  | 
| Provider Name | Ramona M Browning | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1427049006 PECOS PAC ID: 2264694082 Enrollment ID: I20120424000249  | 
| Provider Name | Katherine Kustes Holland | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1588909287 PECOS PAC ID: 1759535081 Enrollment ID: I20130213000560  | 
| Provider Name | Timothy V Welsh | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1124368816 PECOS PAC ID: 3476798661 Enrollment ID: I20130315000444  | 
| Provider Name | Jaclyne Ann Buzzell | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740464130 PECOS PAC ID: 4183705874 Enrollment ID: I20130618000672  | 
| Provider Name | Arthi Devaraju Kaundar | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1184853590 PECOS PAC ID: 9234370321 Enrollment ID: I20130801000510  | 
| Provider Name | Sarah J Carter | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1871821363 PECOS PAC ID: 6103007836 Enrollment ID: I20131004000172  | 
| Provider Name | John M Mccurdy | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1699092510 PECOS PAC ID: 5890922967 Enrollment ID: I20131217000304  | 
| Provider Name | Janet M Kennedy | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1629052279 PECOS PAC ID: 3779808142 Enrollment ID: I20150205000852  | 
| Provider Name | Barbara Ann Williams | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1316351208 PECOS PAC ID: 3678899168 Enrollment ID: I20150227000419  | 
| Provider Name | Aisha Ali | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1457523532 PECOS PAC ID: 5597081091 Enrollment ID: I20150227000764  | 
| Provider Name | Miranda J Coole | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1871740175 PECOS PAC ID: 2163548652 Enrollment ID: I20150715000705  | 
| Provider Name | Susan Gail Cahill | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1366843427 PECOS PAC ID: 5395066146 Enrollment ID: I20150720001677  | 
| Provider Name | Jennifer N Monroe | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1225312630 PECOS PAC ID: 5698083384 Enrollment ID: I20150929003216  | 
| Provider Name | Tonia M Snyder-myers | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1659742914 PECOS PAC ID: 1759685290 Enrollment ID: I20160203002830  | 
| Provider Name | Paula W. Minervino | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1750738936 PECOS PAC ID: 6901197318 Enrollment ID: I20160615000625  | 
| Provider Name | Sean F Martindale | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1003027228 PECOS PAC ID: 0941596860 Enrollment ID: I20160901000893  | 
| Provider Name | Erica L Thomas | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1982157046 PECOS PAC ID: 7315234838 Enrollment ID: I20160928000257  | 
| Provider Name | Melissa Hines | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801343140 PECOS PAC ID: 3375830565 Enrollment ID: I20161003002450  | 
| Provider Name | Jaseena Elikkottil | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1407096233 PECOS PAC ID: 0042452765 Enrollment ID: I20161205001400  | 
| Provider Name | Ngoc Uyen Nguyen | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1487063137 PECOS PAC ID: 7810267531 Enrollment ID: I20170727002819  | 
| Provider Name | Emmalee R Burns | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1649799040 PECOS PAC ID: 3870867146 Enrollment ID: I20170928003503  | 
| Provider Name | Terrica Michelle Flowers | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1528587789 PECOS PAC ID: 7911265848 Enrollment ID: I20171221002106  | 
| Provider Name | Greta Bakanowski | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1245744960 PECOS PAC ID: 8729341177 Enrollment ID: I20180504000119  | 
| Provider Name | Dana Singletary | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1518453075 PECOS PAC ID: 7810245495 Enrollment ID: I20180731000577  | 
| Provider Name | Mary Alane Sallee | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1043779895 PECOS PAC ID: 0446592257 Enrollment ID: I20190426001681  | 
| Provider Name | Pamela Lynn Ratcliffe | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1609431097 PECOS PAC ID: 1759614845 Enrollment ID: I20190604002908  | 
| Provider Name | Jennifer Christine Angermeier | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699296293 PECOS PAC ID: 6507293081 Enrollment ID: I20200221001771  | 
| Provider Name | Patricia Guzman Rojas | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1164874160 PECOS PAC ID: 1456776806 Enrollment ID: I20200803001993  | 
| Provider Name | Samantha J Davis | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1265785224 PECOS PAC ID: 1456681444 Enrollment ID: I20200826003438  | 
| Provider Name | Sheana J Pryor | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1750561304 PECOS PAC ID: 6305264623 Enrollment ID: I20200917001590  | 
| Provider Name | Kellee Lynn Duke | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1407522147 PECOS PAC ID: 1850797820 Enrollment ID: I20210831002394  | 
| Provider Name | Siham Shamy Nabil | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699435529 PECOS PAC ID: 5799177234 Enrollment ID: I20220113001701  | 
| Provider Name | Natasha Lee Sanders | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720730773 PECOS PAC ID: 0143613661 Enrollment ID: I20220205000142  | 
| Provider Name | Sarah E Hardesty | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1417618489 PECOS PAC ID: 3577957182 Enrollment ID: I20220224002133  | 
| Provider Name | Tabitha Jeanne Davis | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1700532967 PECOS PAC ID: 5799163218 Enrollment ID: I20220610002486  | 
| Provider Name | Elizabeth J Logsdon | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1275272197 PECOS PAC ID: 3375922263 Enrollment ID: I20220623001693  | 
| Provider Name | Kathleen Marie High | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1124032743 PECOS PAC ID: 0345620944 Enrollment ID: I20220628003824  | 
| Provider Name | Courtney Marie Pike | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1477274728 PECOS PAC ID: 4486030103 Enrollment ID: I20221004002478  | 
| Provider Name | Alicia Waldrab | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205399482 PECOS PAC ID: 0345571196 Enrollment ID: I20221021002166  | 
| Provider Name | Timara Coppa | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1972111235 PECOS PAC ID: 9739556515 Enrollment ID: I20221108001367  | 
| Provider Name | Jennifer Lynn Avis | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1467179721 PECOS PAC ID: 9537537097 Enrollment ID: I20221115001870  | 
| Provider Name | Kim S Hammonds | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1912437526 PECOS PAC ID: 2264897529 Enrollment ID: I20230420002889  | 
| Provider Name | Elizabeth Hargadon Van Cleave | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1053011387 PECOS PAC ID: 7719342377 Enrollment ID: I20230503003002  | 
| Provider Name | Tierra Denise Decker | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538869615 PECOS PAC ID: 8921463456 Enrollment ID: I20230504003185  | 
| Provider Name | Charles Kleymeyer Welsh | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1710675707 PECOS PAC ID: 4880050913 Enrollment ID: I20230516002564  | 
| Provider Name | Alicia Nicole Bradley | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1992453849 PECOS PAC ID: 8921465386 Enrollment ID: I20230613001235  | 
| Provider Name | Stephanie Nicole Luckett | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1003224833 PECOS PAC ID: 7719271329 Enrollment ID: I20231221003846  | 
| Provider Name | Mckenzie Bond Buckel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1356114417 PECOS PAC ID: 2466802939 Enrollment ID: I20231223000188  | 
| Provider Name | Marcus A Gibson | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1811029010 PECOS PAC ID: 8022320092 Enrollment ID: I20240111003125  | 
| Provider Name | Neviana Dimova | 
|---|---|
| Provider Type | Practitioner - General Practice | 
| Provider Identifiers | NPI Number: 1558929893 PECOS PAC ID: 5294164638 Enrollment ID: I20240221002567  | 
| Provider Name | Alexey Acosta Quintana | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639818867 PECOS PAC ID: 7618316001 Enrollment ID: I20240418000698  | 
| Provider Name | Amanda K Gullion | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1881445518 PECOS PAC ID: 8022459288 Enrollment ID: I20240518000515  | 
| Provider Name | Stephanie A Poynter | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1245236892 PECOS PAC ID: 0244542082 Enrollment ID: I20240626000444  | 
| Provider Name | Sarah Margaret Cohron | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1790555829 PECOS PAC ID: 5294279626 Enrollment ID: I20240626003915  | 
| Provider Name | Allison M Mclane Dezarn | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1548234685 PECOS PAC ID: 2567775588 Enrollment ID: I20240924002873  | 
| Provider Name | Paola Maria Galan Villar | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1831779016 PECOS PAC ID: 0345640850 Enrollment ID: I20240925000229  | 
| Provider Name | Shamecka Sullivan | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1023840717 PECOS PAC ID: 1456883297 Enrollment ID: I20241017001137  | 
| Provider Name | Teresa L Phillips | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1437515194 PECOS PAC ID: 4486001245 Enrollment ID: I20241022005174  | 
| Provider Name | Bradley Randall Congleton | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1952754749 PECOS PAC ID: 3476898750 Enrollment ID: I20241204001898  | 
Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15103 Chestnut Ridge Cir, Louisville, KY 40245 Phone: 502-742-9149 Fax: 502-896-7292  | |
Veloz Medical Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6911 Shepherdsville Rd, Louisville, KY 40219 Phone: 502-644-3076  | |
Kentucky Joint Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4010 Dupont Cir Ste 310, Louisville, KY 40207 Phone: 502-771-5432 Fax: 502-771-5430  | |
Edina Torlak Md, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 Kresge Way Ste 302, Louisville, KY 40207 Phone: 502-893-7372  | |
Shirley J Meredith, Md, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4000 Kresge Way, Baptist East Wound Care Center, Louisville, KY 40207 Phone: 502-259-4470 Fax: 502-259-4471  | |
Infectious Disease Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Locust Creek Blvd, Louisville, KY 40245 Phone: 502-916-3130 Fax: 502-916-3230  | |
Deer Park Family Doctors Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1603 Stevens Ave, Louisville, KY 40205 Phone: 502-451-5955 Fax: 502-451-5925  |