1154370856 NPI number — BARBARA J LEMMONS ARNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154370856 NPI number — BARBARA J LEMMONS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEMMONS
Provider First Name:
BARBARA
Provider Middle Name:
J
Provider Name Prefix Text:
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:
1154370856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 21890
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-4115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-907-0356
Provider Business Mailing Address Fax Number:
502-919-9780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 EXECUTIVE PARK
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:
40207-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-855-7200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2006

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: 363LA2200X , with the licence number:  710040710A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 3004548 , 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: 000001004596 . This is a "ANTHEM ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1233814 . This is a "WELLCARE OF KY PROVIDER ID NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: CS1809600114 . This is a "CARESOURCE ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7452751 . This is a "AETNA PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: PDZ000000060717 . This is a "AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300006948 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 78016219 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002626273 . This is a "UNITED HEALTHCARE PROVIDER ID NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9168085 . This is a "CIGNA PROVIDER ID NUMBER" identifier . This identifiers is of the category "OTHER".




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