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KENTUCKY BLUE MEDICAL LLC
NPI 1063862506
Neuromusculoskeletal Medicine & OMM in Louisville, KY

Active since June 15, 2016
4602 SOUTHERN PKWY STE 1A, LOUISVILLE, KY 40214(502) 361-1159 Get Directions Write a Review

NPPES record last updated: June 15, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Kentucky Blue Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENTUCKY BLUE MEDICAL LLC (NPI 1063862506) is a healthcare organization registered as a neuromusculoskeletal medicine & omm in Louisville, Kentucky and active in the NPI registry since June 2016. The organization lists Cranston Sheppard, Owner, as its authorized official.

NPPES Registry Identity

NPI1063862506
Entity TypeOrganization
Primary Taxonomy204D00000X
Legal Business NameKENTUCKY BLUE MEDICAL LLC
Location Address4602 SOUTHERN PKWY STE 1ALouisville, KY 40214-1442
Mailing Address4602 Southern Pkwy Ste 1aLouisville, KY 40214-1442
Phone(502) 361-1159
Organization SubpartNo
Authorized OfficialCranston SheppardOwner · (502) 361-1159
Enumeration DateJune 15, 2016
✔ NPI 1063862506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians
Taxonomy Code204D00000X
Definition
The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.
4602 SOUTHERN PKWY STE 1A, Louisville, KY 40214
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APRIL ROANN ROBERTSON
Peer Specialist
4602 SOUTHERN PKWY STE 1A
LOUISVILLE, KY 40214
Jefferson County (270) 300-6819
SOUTHERN PARKWAY CHIROPRACTIC PLLC
Chiropractor
4602 SOUTHERN PKWY STE 1A
LOUISVILLE, KY 40214
Jefferson County (502) 361-1159

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kentucky Blue Medical LLC's NPI number?

The NPI number for Kentucky Blue Medical LLC is 1063862506. It was assigned to this organization in the NPPES registry on June 15, 2016.

Where is Kentucky Blue Medical LLC located?

Kentucky Blue Medical LLC is located at 4602 Southern Pkwy Ste 1A, Louisville, KY 40214. The listed phone number is (502) 361-1159.

What is Kentucky Blue Medical LLC's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

When was this NPI record last updated?

The NPPES record for Kentucky Blue Medical LLC was last updated on June 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.