MOBILE MD HOLDINGS LLC NPI 1023187234

NPI Information

  • NPI: 1023187234
  • Provider Name: MOBILE MD HOLDINGS LLC
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • CLIA Number: 18D2291780
  • Address: 9510 ORMSBY STATION ROAD
    SUITE 100B
    LOUISVILLE, KY
    ZIP 40223
  • Phone: (502) 253-4140

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NPI Details

MOBILE MD HOLDINGS LLC is a geriatric medicine family medicine in Louisville, KY. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. MOBILE MD HOLDINGS LLC NPI is 1023187234. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9510 ORMSBY STATION ROAD
SUITE 100B
LOUISVILLE, KY
ZIP 40223-082
Phone: (502) 253-4140

The provider's authorized official is Donna Cantwell .
The authorized official title is Executive Director and has the following contact phone number (502) 253-4140.

The CLIA number assigned to this NPI record is 18D2291780 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 3/12/2009.

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
1363LA2200XNurse PractitionerAdult HealthNo
2363LF0000XNurse PractitionerFamilyKENTUCKYNo
3207QG0300XFamily MedicineGeriatric Medicine720224KENTUCKYYes

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
178904810MEDICAIDKENTUCKY
29806MEDICARE ID-TYPE UNSPECIFIEDKENTUCKY
365944530MEDICAIDKENTUCKY

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: 11/21/2025

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