| Sandeep Kapoor, Pllc | |
|
2109 Club Vista Pl Louisville KY 40245-5224 | |
| (502) 931-8331 | |
| (502) 348-3275 |
| Full Name | Sandeep Kapoor, Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2109 Club Vista Pl, Louisville, Kentucky |
| Authorized Official Name and Position | Sandeep Kapoor (OWNER) |
| Authorized Official Contact | 5029318331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandeep Kapoor, Pllc Po Box 43896 Louisville KY 40253-0896 Ph: (502) 931-8331 | Sandeep Kapoor, Pllc 2109 Club Vista Pl Louisville KY 40245-5224 Ph: (502) 931-8331 |
| NPI Number | 1235469255 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 08/14/2024 |
| Medicare PECOS PAC ID | 6709913742 |
|---|---|
| Medicare Enrollment ID | O20100422000352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235469255 | NPI | - | NPPES |
| 7100237480 | Medicaid | KY | |
| 7100300360 | Medicaid | KY |
| Provider Name | Sandeep Kapoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043264641 PECOS PAC ID: 9638206683 Enrollment ID: I20100422000463 |
| Provider Name | Ragan N Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023307741 PECOS PAC ID: 5991989808 Enrollment ID: I20110418000223 |
| Provider Name | Shannon Gagliardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063706075 PECOS PAC ID: 6406024793 Enrollment ID: I20110712000136 |
| Provider Name | Kimberly Recktenwald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346603891 PECOS PAC ID: 7810296860 Enrollment ID: I20160426002188 |
| Provider Name | Jennifer Ann Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730696451 PECOS PAC ID: 6406116102 Enrollment ID: I20180126001893 |
| Provider Name | David Walter Koonce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932617453 PECOS PAC ID: 0749540334 Enrollment ID: I20180130000913 |
| Provider Name | Teresa White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437632577 PECOS PAC ID: 9931450913 Enrollment ID: I20181002000962 |
| Provider Name | Johanna S. Coursey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144777335 PECOS PAC ID: 9032454855 Enrollment ID: I20181226002026 |
| Provider Name | Kathleen Tierney Lanham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295388221 PECOS PAC ID: 0244562429 Enrollment ID: I20191022001172 |
| Provider Name | Jeffery Allan Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962097428 PECOS PAC ID: 8628476926 Enrollment ID: I20211015002197 |
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