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SMOKETOWN FAMILY WELLNESS CENTER CORP NPI 1184145815


NPI Information

NPI: 1184145815
Provider Name: SMOKETOWN FAMILY WELLNESS CENTER CORP

Doing Business As: SMOKETOWN FAMILY WELLNESS CENTER

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 18D2140702

Address:
760 S HANCOCK ST APT B100
LOUISVILLE, KY
ZIP 40203
Phone: (502) 242-7458
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SMOKETOWN FAMILY WELLNESS CENTER CORP is a pediatrics in Louisville, KY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SMOKETOWN FAMILY WELLNESS CENTER CORP NPI is 1184145815. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Smoketown Family Wellness Center.

The provider's business location address is:

760 S HANCOCK ST APT B100
LOUISVILLE, KY
ZIP 40203-449
Phone: (502) 242-7458

The provider's authorized official is Charlotte Gay Stites .
The authorized official title is Physician Owner and has the following contact phone number (502) 242-7458.

The CLIA number assigned to this NPI record is 18D2140702 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/3/2017 and was last updated on 10/10/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2363A00000XPhysician AssistantNo
3363L00000XNurse PractitionerNo
4363LP0200XNurse PractitionerPediatricsNo
5208000000XPediatricsYes

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

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