Provider Demographics
NPI:1396850400
Name:DRS. HINKEBEIN, DAVIS & MCCORMICK, PLLC
Entity Type:Organization
Organization Name:DRS. HINKEBEIN, DAVIS & MCCORMICK, PLLC
Other - Org Name:GROWING HEALTHY CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HINKEBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-425-5166
Mailing Address - Street 1:9905 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2907
Mailing Address - Country:US
Mailing Address - Phone:502-425-5166
Mailing Address - Fax:502-327-0526
Practice Address - Street 1:9905 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2907
Practice Address - Country:US
Practice Address - Phone:502-425-5166
Practice Address - Fax:502-327-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY39427OtherCLIA
KY64109564Medicaid
KY7100453570Medicaid