| Hazelwood Specialty Clinic | |
|
1800 Bluegrass Ave Louisville KY 40215-1130 | |
| (502) 361-2301 | |
| (502) 366-0367 |
| Full Name | Hazelwood Specialty Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 Bluegrass Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Jennifer Moore (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 5027826117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hazelwood Specialty Clinic 1800 Bluegrass Ave Louisville KY 40215-1130 Ph: (502) 361-2301 | Hazelwood Specialty Clinic 1800 Bluegrass Ave Louisville KY 40215-1130 Ph: (502) 361-2301 |
| NPI Number | 1114346467 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 08/07/2024 |
| Medicare PECOS PAC ID | 0840180816 |
|---|---|
| Medicare Enrollment ID | O20040316000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114346467 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Richard T Holt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669455630 PECOS PAC ID: 4880687813 Enrollment ID: I20040406000855 |
| Provider Name | Toufic A Fakhoury |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235234394 PECOS PAC ID: 4385653427 Enrollment ID: I20060418000333 |
| Provider Name | Christopher S Ross |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851309140 PECOS PAC ID: 1557362787 Enrollment ID: I20070130000607 |
| Provider Name | Miriam E. Harris-shelton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1255581104 PECOS PAC ID: 9739236381 Enrollment ID: I20090416000446 |
| Provider Name | Elizabeth M Caudill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861426991 PECOS PAC ID: 3274710215 Enrollment ID: I20110531000628 |
| Provider Name | Arun Kaithi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851578579 PECOS PAC ID: 6305005828 Enrollment ID: I20120301000905 |
| Provider Name | Roy Lukat |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1962697573 PECOS PAC ID: 8325292949 Enrollment ID: I20130207000350 |
| Provider Name | Ashima K Gupta |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1073509592 PECOS PAC ID: 8921100066 Enrollment ID: I20131003000109 |
| Provider Name | Tiffany R Mcintyre |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205801875 PECOS PAC ID: 1658501994 Enrollment ID: I20140314001500 |
| Provider Name | Seema V Kulkarni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902229305 PECOS PAC ID: 6709018765 Enrollment ID: I20140407001527 |
| Provider Name | Len Coughlin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932515814 PECOS PAC ID: 4082933593 Enrollment ID: I20150505002362 |
| Provider Name | Kary Susan Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902178452 PECOS PAC ID: 6901127794 Enrollment ID: I20150604002396 |
| Provider Name | Sarah Elizabeth Cassol |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649366097 PECOS PAC ID: 0244543064 Enrollment ID: I20150722003894 |
| Provider Name | Elsa E Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255724332 PECOS PAC ID: 5496069189 Enrollment ID: I20150810001156 |
| Provider Name | Kimberly Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316323850 PECOS PAC ID: 5193032506 Enrollment ID: I20150917001581 |
| Provider Name | Allison Roe |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1629485388 PECOS PAC ID: 4082912811 Enrollment ID: I20160412001818 |
| Provider Name | Modupe C. Adesola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184076770 PECOS PAC ID: 7618262403 Enrollment ID: I20160817003019 |
| Provider Name | Ashley Hill |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1073062634 PECOS PAC ID: 7810267945 Enrollment ID: I20170724001774 |
| Provider Name | Carolyne C Kimeli-mbaraka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861932253 PECOS PAC ID: 8224300942 Enrollment ID: I20170815004405 |
| Provider Name | Lydia Clare Coughlin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1316458987 PECOS PAC ID: 4385903319 Enrollment ID: I20180118002641 |
| Provider Name | Hayley Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366937260 PECOS PAC ID: 5092062695 Enrollment ID: I20180726002974 |
| Provider Name | Ashley Nicole Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508358359 PECOS PAC ID: 2668724105 Enrollment ID: I20181010002112 |
| Provider Name | Earl Edward Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013111459 PECOS PAC ID: 1557608866 Enrollment ID: I20190124001944 |
| Provider Name | Sheila Marie Kemper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811252638 PECOS PAC ID: 1557671963 Enrollment ID: I20190307002108 |
| Provider Name | Lydia Marie Coots |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467928895 PECOS PAC ID: 0840629879 Enrollment ID: I20200326001771 |
| Provider Name | Brianna Flanigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891303319 PECOS PAC ID: 6406271717 Enrollment ID: I20200804001326 |
| Provider Name | Dakota R Hangartner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396348470 PECOS PAC ID: 6901219310 Enrollment ID: I20210104000701 |
| Provider Name | Kasey Olivia Mcintyre |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871979039 PECOS PAC ID: 0648617928 Enrollment ID: I20240321003930 |
| Provider Name | Regina Winburn |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396151635 PECOS PAC ID: 9931547411 Enrollment ID: I20240403000657 |
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 | |
Mobile Md Holdings Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9510 Ormsby Station Road, Suite 100b, Louisville, KY 40223 Phone: 502-253-4140 | |
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 |