1265416259 NPI number — TINA F SIMPSON MD

Table of content: TINA F SIMPSON MD (NPI 1265416259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265416259 NPI number — TINA F SIMPSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMPSON
Provider First Name:
TINA
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265416259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-588-9490
Provider Business Mailing Address Fax Number:
502-272-5116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4801 OLYMPIA PARK PLZ
Provider Second Line Business Practice Location Address:
SUITE 2200
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40241-2090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-423-9595
Provider Business Practice Location Address Fax Number:
502-719-0161
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  31256 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000044684 . This is a "BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50037682 . This is a "PASSPORT - WOMEN'S SPECIALISTS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 610679864F . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1058742 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 160029909 . This is a "RR MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 134800 . This is a "SIHO - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64312564 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000765748 . This is a "ANTHEM - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50037682 . This is a "PASSPORT - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com