1215953088 NPI number — DR. RITA FLEMING MD

Table of content: DR. RITA FLEMING MD (NPI 1215953088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215953088 NPI number — DR. RITA FLEMING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLEMING
Provider First Name:
RITA
Provider Middle Name:
Provider Name Prefix Text:
DR.
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:
1215953088
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 S JACKSON ST FL ST2
Provider Second Line Business Mailing Address:
DEPT OB/GYN ATT: VICKI MASTERSON
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-5700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-271-5999
Provider Business Practice Location Address Fax Number:
502-271-5994
Provider Enumeration Date:
07/14/2006

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: 207V00000X , with the licence number:  24679 , 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: 100322820 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50003185 . This is a "PASSPORT SPECIALITY # - PSC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50003186 . This is a "PASSPORT SPECIALITY - FOUNDATION" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000359399 . This is a "ANTHEM - PSC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50003184 . This is a "PASSPORT PCP# - FOUNDATION" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64246796 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000003574880 . This is a "ANTHEM - FOUNDATION" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00533087 . This is a "MEDICARE KY FOR NORTON'S HOSPITAL EFF DATE 11-16-08" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com