| NPI | 1255354361 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-07-26 |
| Last Updated | 2021-11-02 |
| Authorized Official | Swannie Jett CEO Phone: 5027744401 |
| Mailing Address | 3015 Wilson Ave Louisville, KY 40211-1969 United States Phone: (502) 774-4401 | Fax: (502) 772-4783 📍 View Map |
| Primary Practice Address | 1425 W. Broadway Louisville, KY 40202 United States Phone: (502) 584-2992 | Fax: (502) 584-3715 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | KY | 31000011 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC) | KY | 700005 |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1255354361
Park Duvalle Community Health Center, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1255354361. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Louisville, KY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1255354361?
NPI 1255354361 belongs to Park Duvalle Community Health Center, Inc., a Clinic/Center, Federally Qualified Health Center (FQHC) in Louisville, KY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1255354361 active?
The current status of NPI 1255354361 in the NPPES registry is Active. The record was last updated on 2021-11-02.
What specialty is NPI 1255354361?
NPI 1255354361 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1255354361?
You can verify NPI 1255354361 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1255354361?
The primary practice address on file for NPI 1255354361 is 1425 W. Broadway, Louisville, KY 40202. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1255354361 issued?
NPI 1255354361 was first issued (enumerated) on 2006-07-26. The NPPES record was last updated on 2021-11-02.
Practice Location Map
Park Duvalle Community Health Center, Inc. is located at 1425 W. Broadway, Louisville, KY. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Park Duvalle Community Health Center, Inc.. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1255354361. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Clinic/Center, Federally Qualified Health Center (FQHC) | 700005 | KY |