=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144414301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARTNERS IN PATIENT CARE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2007
-----------------------------------------------------
Last Update Date | 08/30/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 340 CHAPEZE LN
-----------------------------------------------------
City | SHEPHERDSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40165-8893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-921-2963
-----------------------------------------------------
Fax | 502-921-2963
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 340 CHAPEZE LN
-----------------------------------------------------
City | SHEPHERDSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40165-8893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-921-2963
-----------------------------------------------------
Fax | 502-921-2963
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER-MANAGER
-----------------------------------------------------
Name | MRS. EMILY ANNE BAILEY
-----------------------------------------------------
Credential | ARNP, FNP-C
-----------------------------------------------------
Telephone | 502-921-2963
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | 4234P
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 313M00000X
-----------------------------------------------------
Taxonomy Name | Nursing Facility/Intermediate Care Facility
-----------------------------------------------------
License Number | 4234P
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 4234P
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------