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NPI Code Detail

MEDICARE: KINDRED HOSPITAL LOUISVILLE

MEDICARE: KINDRED HOSPITAL LOUISVILLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DB2622OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
250005946OTHERPASSPORT
3000000355124OTHERANTHEM BCBS
4447236000OTHERPASSPORT ADVANTAGE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235271081
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINDRED HOSPITAL LOUISVILLE
Provider Business Mailing Address
First Line : 680 S 4TH ST # KH-3
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-2407
Country : US
Telephone Number : 502-596-6063
Fax Number :
Provider Business Practice Location Address
First Line : 1313 SAINT ANTHONY PL
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1740
Country : US
Telephone Number : 502-627-1100
Fax Number :
Authorized Official
Title or Position : AO
Name : JOHNETTA TRAYLOR
Credential :
Telephone Number : 502-596-6063
Provider Enumeration Date : 02/12/2007
Last Update Date : 06/23/2025

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Directions to “KINDRED HOSPITAL LOUISVILLE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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