MEDICARE: KND DEVELOPMENT 59, LLC

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	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1922950823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KND DEVELOPMENT 59, LLC

Provider Business Mailing Address
First Line	:	680 S 4TH ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-2407
Country	:	US
Telephone Number	:	502-596-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W BOISE CIR FL 3
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-4900
Country	:	US
Telephone Number	:	918-682-6161
Fax Number	:

Authorized Official
Title or Position	:	DVP REVENUE CYCLE
Name	:	LINDA L FISHER
Credential	:
Telephone Number	:	502-596-7358

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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