VANDERBILT INTEGRATED PROVIDERS NPI 1255463949

NPI Information

  • NPI: 1255463949
  • Provider Name: VANDERBILT INTEGRATED PROVIDERS
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • Doing Business As: PEDIATRIC ASSOCIATES
  • Address: 1717 HIGH STREET
    SUITE 3A
    HOPKINSVILLE, KY
    ZIP 42240
  • Phone: (270) 885-8445

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NPI Details

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
1363LP0200XNurse PractitionerPediatricsNo
2363LP0200XNurse PractitionerPediatrics3002428KENTUCKYYes
3363LP0200XNurse PractitionerPediatrics3004549KENTUCKYNo

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
178900800MEDICAIDKENTUCKY

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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