DR. WAYNE NELSON STARK M.D. NPI 1215246202

NPI Information

NPI: 1215246202
Provider Name: DR. WAYNE NELSON STARK, M.D.
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
4001 DUTCHMANS LN
LOUISVILLE, KY
ZIP 40207
Phone: (502) 599-3930
Get Directions

DR. Wayne Nelson Stark, M.D. is a pediatric emergency medicine pediatrics in Louisville, KY. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Wayne Nelson Stark, M.D. NPI is 1215246202. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4001 DUTCHMANS LN
LOUISVILLE, KY
ZIP 40207-714
Phone: (502) 599-3930
Fax: (502) 559-4605

The NPI 1215246202 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/25/2010 and was last updated on 4/29/2021.

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	208000000X	Pediatrics		45095	KENTUCKY	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	45095	KENTUCKY	Yes
3	2080P0204X	Pediatrics	Pediatric Emergency Medicine	ME123631	FLORIDA	No

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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