| 360care Llc | |
|
12910 Shelbyville Rd Ste 300 Louisville KY 40243-2404 | |
| (502) 244-2441 | |
| (502) 996-8282 |
| Full Name | 360care Llc |
|---|---|
| Speciality | Dentist |
| Location | 12910 Shelbyville Rd Ste 300, Louisville, Kentucky |
| Authorized Official Name and Position | Randy Ammon (MANAGER) |
| Authorized Official Contact | 5022442440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360care Llc 12910 Shelbyville Rd Ste 128 Louisville KY 40243-1536 Ph: (502) 244-2441 | 360care Llc 12910 Shelbyville Rd Ste 300 Louisville KY 40243-2404 Ph: (502) 244-2441 |
| NPI Number | 1417592536 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 02/05/2020 |
| Medicare PECOS PAC ID | 2860708666 |
|---|---|
| Medicare Enrollment ID | O20200310001966 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417592536 | NPI | - | NPPES |
| Provider Name | John Janvier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346429503 PECOS PAC ID: 3870498959 Enrollment ID: I20031203000032 |
| Provider Name | Dwayne Aubrey Jacobus |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295726172 PECOS PAC ID: 4082686647 Enrollment ID: I20040816000075 |
| Provider Name | Chad Byron Fox |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093739864 PECOS PAC ID: 6901870302 Enrollment ID: I20040823000320 |
| Provider Name | Paul J Keane |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194829838 PECOS PAC ID: 2668408329 Enrollment ID: I20050713001052 |
| Provider Name | Thomas J Patrick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992726319 PECOS PAC ID: 3375578263 Enrollment ID: I20050929000190 |
| Provider Name | Charlotte C Holman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003080342 PECOS PAC ID: 7911086590 Enrollment ID: I20080507000497 |
| Provider Name | Kelly A Long |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1457438905 PECOS PAC ID: 4486716297 Enrollment ID: I20090102000169 |
| Provider Name | Heather H Armstrong |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1194909333 PECOS PAC ID: 7113000654 Enrollment ID: I20090708000740 |
| Provider Name | Adrienne Migayle Atkinson-sneed |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366462699 PECOS PAC ID: 1658452909 Enrollment ID: I20090812000453 |
| Provider Name | Norris R Philbeck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275608499 PECOS PAC ID: 9537337597 Enrollment ID: I20110718000288 |
| Provider Name | Karl J Kleinau |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598760894 PECOS PAC ID: 7911063581 Enrollment ID: I20120118000318 |
| Provider Name | Aliya Fagan Matthews |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1487819173 PECOS PAC ID: 1658551726 Enrollment ID: I20150730013618 |
| Provider Name | Ashley Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1851725824 PECOS PAC ID: 5193025666 Enrollment ID: I20151207000155 |
| Provider Name | Andrew Feltz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225037393 PECOS PAC ID: 4880668235 Enrollment ID: I20160420001924 |
| Provider Name | Kelli Mccartney |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811201692 PECOS PAC ID: 2264614213 Enrollment ID: I20170801000776 |
| Provider Name | Kathleen Clary |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609849389 PECOS PAC ID: 5890724116 Enrollment ID: I20171227000386 |
| Provider Name | Annette M Joyce, |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316997471 PECOS PAC ID: 5294648051 Enrollment ID: I20180718004257 |
| Provider Name | Miranda R. Ross |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1386830578 PECOS PAC ID: 0446332191 Enrollment ID: I20180926000639 |
| Provider Name | Jennifer Joyce Camp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083604664 PECOS PAC ID: 8022362037 Enrollment ID: I20181109001981 |
| Provider Name | Virginia Chetverikov |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093745861 PECOS PAC ID: 2365597416 Enrollment ID: I20190122003557 |
| Provider Name | Ian Harold Barker |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629413604 PECOS PAC ID: 1052604279 Enrollment ID: I20190306000606 |
| Provider Name | Renu Mathew |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831112911 PECOS PAC ID: 3375626369 Enrollment ID: I20200312001307 |
| Provider Name | John R Seymour |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841251741 PECOS PAC ID: 8224141411 Enrollment ID: I20200513003056 |
| Provider Name | Francesca Rose Sikorski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629641584 PECOS PAC ID: 5890199483 Enrollment ID: I20210804000685 |
| Provider Name | Laurel Eng |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073095766 PECOS PAC ID: 8224374582 Enrollment ID: I20220531000694 |
| Provider Name | Deborah J Albaugh |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1811053382 PECOS PAC ID: 4981891769 Enrollment ID: I20221111000616 |
| Provider Name | Sade Crowley |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417383530 PECOS PAC ID: 7113151770 Enrollment ID: I20240321003092 |
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