Provider Demographics
NPI:1093771164
Name:NEUROSURGICAL INSTITUTE OF KENTUCKY
Entity Type:Organization
Organization Name:NEUROSURGICAL INSTITUTE OF KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-583-1697
Mailing Address - Street 1:210 E GRAY ST
Mailing Address - Street 2:SUITE 1105
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3900
Mailing Address - Country:US
Mailing Address - Phone:502-583-1697
Mailing Address - Fax:502-583-4085
Practice Address - Street 1:210 E GRAY ST
Practice Address - Street 2:SUITE 1105
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3900
Practice Address - Country:US
Practice Address - Phone:502-583-1697
Practice Address - Fax:502-583-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100016240AMedicaid
KY65910499Medicaid
KY2755Medicare ID - Type Unspecified
IN170880Medicare ID - Type Unspecified