| Louisville Internal Medicine & Pediatrics, Llc | |
|
3101 Breckenridge Ln #4e Louisville KY 40220-2742 | |
| (502) 454-5252 | |
| (502) 454-5353 |
| Full Name | Louisville Internal Medicine & Pediatrics, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3101 Breckenridge Ln, Louisville, Kentucky |
| Authorized Official Name and Position | Clara Ann Pallares (PRESIDENT) |
| Authorized Official Contact | 5024545252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Internal Medicine & Pediatrics, Llc 3101 Breckenridge Ln #4e Louisville KY 40220-2742 Ph: (502) 454-5252 | Louisville Internal Medicine & Pediatrics, Llc 3101 Breckenridge Ln #4e Louisville KY 40220-2742 Ph: (502) 454-5252 |
| NPI Number | 1265567572 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 09/29/2010 |
| Medicare PECOS PAC ID | 1153391016 |
|---|---|
| Medicare Enrollment ID | O20040728000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265567572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 30532 (Kentucky) | Primary |
| 208000000X | Pediatrics | 30532 (Kentucky) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 002051P (Kentucky) | Secondary |
| Provider Name | Clara Ann Pallares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124092366 PECOS PAC ID: 8224008180 Enrollment ID: I20040730000221 |
| Provider Name | Brittany Kirchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831636406 PECOS PAC ID: 9234412867 Enrollment ID: I20170206002328 |
| Provider Name | Jessica Kremer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902369010 PECOS PAC ID: 0941542807 Enrollment ID: I20190425002272 |
| Provider Name | Lindsey Nicole Mcpherson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003409202 PECOS PAC ID: 5991110942 Enrollment ID: I20210224002793 |
| Provider Name | Deanna Marie Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487305363 PECOS PAC ID: 6002209517 Enrollment ID: I20220204001953 |
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