1982963872 NPI number — GASTROENTEROLOGY HEALTH PARTNERS, PLLC

Table of content: (NPI 1982963872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982963872 NPI number — GASTROENTEROLOGY HEALTH PARTNERS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GASTROENTEROLOGY HEALTH PARTNERS, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1982963872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE GI CREDENTIALING DEPARTMENT
Provider Second Line Business Mailing Address:
PO BOX 381468
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38183-1468
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
901-328-1355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1941 BISHOP LN
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
LOUSIVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-888-1988
Provider Business Practice Location Address Fax Number:
502-452-6577
Provider Enumeration Date:
05/11/2012

Additional Information

Authorized Official

Authorized Official Last Name:
JUDY
Authorized Official First Name:
AIMEE
Authorized Official Middle Name:
CATHLEEN
Authorized Official Title or Position:
DIRECTOR, CREDENTIALING
Authorized Official Telephone Number:
901-737-4665

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 300022756 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100371700 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100505380 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201161010A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100236330 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100473430 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100477300 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com