THR PEDIATRICS & WELLNESS CENTER NPI 1184293862

NPI Information

NPI: 1184293862
Provider Name: THR PEDIATRICS & WELLNESS CENTER
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

CLIA Number: 18D2227310

Address:
7098 DISTRIBUTION DR STE A
LOUISVILLE, KY
ZIP 40258
Phone: (502) 749-8019
Get Directions

THR PEDIATRICS & WELLNESS CENTER is a medical physician assistant in Louisville, KY. THR PEDIATRICS & WELLNESS CENTER NPI is 1184293862. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7098 DISTRIBUTION DR STE A
LOUISVILLE, KY
ZIP 40258-879
Phone: (502) 749-8019
Fax: (833) 755-1833

The provider's authorized official is Tyeshia Chlotiel Halsell Richards .
The authorized official title is Pediatric Physician Assistant and has the following contact phone number (502) 500-8955.

The CLIA number assigned to this NPI record is 18D2227310 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/17/2021 and was last updated on 11/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100773670	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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