1063496412 NPI number — MRS. MELISSA SCHEENE HARDIN ARNP

Table of content: JONATHAN SHOUHED DDS (NPI 1962836650)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063496412 NPI number — MRS. MELISSA SCHEENE HARDIN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDIN
Provider First Name:
MELISSA
Provider Middle Name:
SCHEENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1063496412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 766351
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60677-6351
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:
213 N HURSTBOURNE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40222-5139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-327-5135
Provider Business Practice Location Address Fax Number:
502-327-9475
Provider Enumeration Date:
11/30/2005

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: 363L00000X , with the licence number:  4170P , 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: 000000545920 . This is a "ANTHEM INDIANA MEDICAID- NORTON COMMUNITY MEDICAL ASSOCIATES" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000545920 . This is a "ANTHEM- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200909260 . This is a "MANAGED HEALTH SERVICES- NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000023029T . This is a "HUMANA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100038950 . This is a "MEDICAID- NORTON CMA- HURSTBOURNE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50018634 . This is a "PASSPORT- NORTON CMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 093446 . This is a "SIHO- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200909260 . This is a "MEDICAID IN- NORTON CMA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200909260 . This is a "MD WISE- NORTON COMMUNITY MEDICAL ASSOCIATES" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3503561000 . This is a "PASSPORT ADVANTAGE- NORTON CMA- HURSTBOURNE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1434799 . This is a "CIGNA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00676684 . This is a "RAILROAD MEDICARE- NORTON COMMUNITY MEDICAL ASSOCIATES" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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