Provider Demographics
NPI:1346458502
Name:SCHERFFIUS, TERESA ANN
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:SCHERFFIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 S POPE LICK RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-4600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4233 BARDSTOWN RD
Practice Address - Street 2:STE 100C
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3280
Practice Address - Country:US
Practice Address - Phone:502-493-3800
Practice Address - Fax:502-493-3830
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000179063OtherANTHEM INSURANCE PROVIDER
KY000000179063OtherANTHEM INSURANCE PROVIDER