VANDERBILT INTEGRATED PROVIDERS NPI 1255463949

NPI Information

NPI: 1255463949
Provider Name: VANDERBILT INTEGRATED PROVIDERS

Doing Business As: PEDIATRIC ASSOCIATES

Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
1717 HIGH STREET
SUITE 3A
HOPKINSVILLE, KY
ZIP 42240
Phone: (270) 885-8445
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VANDERBILT INTEGRATED PROVIDERS is a pediatrics nurse practitioner in Hopkinsville, KY. VANDERBILT INTEGRATED PROVIDERS NPI is 1255463949. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Pediatric Associates.

The provider's business location address is:

1717 HIGH STREET
SUITE 3A
HOPKINSVILLE, KY
ZIP 42240
Phone: (270) 885-8445
Fax: (270) 886-9106

The provider's authorized official is Chris Westbrook .
The authorized official title is Assistant Director and has the following contact phone number (615) 936-5187.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 2/27/2013.

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	363LP0200X	Nurse Practitioner	Pediatrics			No
2	363LP0200X	Nurse Practitioner	Pediatrics	3002428	KENTUCKY	Yes
3	363LP0200X	Nurse Practitioner	Pediatrics	3004549	KENTUCKY	No

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	78900800	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: 5/5/2024

NPI Synchronization or Removal

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