Healthcare Provider Details

I. General information

NPI: 1811152192
Provider Name (Legal Business Name): VIP IMAGING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BLUEGRASS AVE
LOUISVILLE KY
40215-1161
US

IV. Provider business mailing address

8101 HOUSTON LN
PEWEE VALLEY KY
40056-9018
US

V. Phone/Fax

Practice location:
  • Phone: 655-847-3768
  • Fax:
Mailing address:
  • Phone: 865-584-7376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number35827
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number35827
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35827
License Number StateKY

VIII. Authorized Official

Name: DR. SEAN LADSON
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 502-432-2299