MEDICARE: LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT

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
1	251K00000X	Public Health or Welfare Agency	251K000004	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1051423	OTHER	KY	PASSPORT MANAGED CARE NUM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255466926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT

Provider Business Mailing Address
First Line	:	400 E GRAY ST
Second Line	:	P. O. BOX 1704
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1740
Country	:	US
Telephone Number	:	502-574-5652
Fax Number	:	502-574-6417

Provider Business Practice Location Address
First Line	:	914 E BROADWAY STE 102
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1184
Country	:	US
Telephone Number	:	502-574-6699
Fax Number	:	502-574-5922

Authorized Official
Title or Position	:	FISCAL MANAGER
Name	:	MS. ROBYN DICKERSON
Credential	:	MSM
Telephone Number	:	502-574-6580

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	04/22/2024

Similar Medicare Providers

1164377578 — BROOKE ELIZABETH HASL
Practice Location Address:

914 E BROADWAY STE 125
LOUISVILLE, KY
40204-1184

Practice Phone: 502-587-8833
Practice Fax:

1073242061 — MALEEYAH K GUMBS
Practice Location Address:

914 E BROADWAY STE 125
LOUISVILLE, KY
40204-1184

Practice Phone: 502-587-8833
Practice Fax:

1831768985 — ABIGAIL KATHERINE SMITH MSSW
Practice Location Address:

914 E BROADWAY STE 125
LOUISVILLE, KY
40204-1184

Practice Phone: 502-589-8600
Practice Fax: 502-589-8745

1811375785 — COMMUNITY CARE OF KENTUCKY, INC.
Practice Location Address:

2500 W BROADWAY STE 100
LOUISVILLE, KY
40211-1184

Practice Phone: 502-776-1754
Practice Fax: 502-778-2301

1295302636 — GLADSTONE MOBILE HEALTHCARE LLC
Practice Location Address:

2500 W BROADWAY STE 100
LOUISVILLE, KY
40211-1184

Practice Phone: 502-888-9181
Practice Fax:

1467390195 — ON TIME HEALTH TRANSPORT
Practice Location Address:

1113 BAXTER AVE APT 3
LOUISVILLE, KY
40204-1658

Practice Phone: 502-819-5174
Practice Fax:

Directions to “LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.