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KENTUCKIANA MEDICINE
NPI 1104229426
General Practice in Jeffersonvlle, IN

Active since October 01, 2014CLIA 15D2255310 · Waiver
443 SPRING ST, SUITE 303, JEFFERSONVLLE, IN 47130(812) 913-4416(812) 213-8408 Get Directions Write a Review

NPPES record last updated: October 1, 2014. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Kentuckiana Medicine NPPES

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

KENTUCKIANA MEDICINE (NPI 1104229426) is a healthcare organization registered as a general practice in Jeffersonvlle, Indiana and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through March 13, 2028 and lists Rafael F Cruz, Owner, as its authorized official.

NPPES Registry Identity

NPI1104229426
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameWYOMING MEDICINE AND PHARMACY LLC
Location Address443 SPRING ST, SUITE 303Jeffersonvlle, IN 47130-4494
Mailing Address443 Spring St, Suite 303Jeffersonvlle, IN 47130-4494 · (812) 913-4416 · Fax (812) 213-8408
Phone(812) 913-4416
Fax(812) 213-8408
Organization SubpartNo
Authorized OfficialRafael F CruzOwner · (859) 468-5065
Enumeration DateOctober 1, 2014
✔ NPI 1104229426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
443 SPRING ST, Jeffersonvlle, IN 47130
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Other Names 1

Doing Business AsKentuckiana Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2255310

Dba Kentuckiana Medicine · Jeffersonville, IN
Active · expires Mar 13, 2028
CLIA Number15D2255310
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2026
Certificate Expiration DateMarch 13, 2028
Laboratory DirectorRafael F. Cruz
Laboratory Phone(812) 913-4416
Laboratory LocationDba Kentuckiana Medicine405 East Court Ave Suite 101, Jeffersonville, IN 47130
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

KAYLA RUSHING NP
Nurse Practitioner (Family)
443 SPRING ST
JEFFERSONVILLE, IN 47130
Clark County (812) 288-8360
COMPLETE CARE CHIROPRACTIC & INJURY REHAB
Chiropractor
443 SPRING ST, 2ND FLOOR OF CHASE BANK BLDG
JEFFERSONVILLE, IN 47130
Clark County (502) 387-5181
WYOMING PHARMACIES LLC
Pharmacist
443 SPRING ST, SUITE 303
JEFFERSONVILLE, IN 47130
Clark County (812) 590-2355

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 Wyoming Medicine And Pharmacy LLC's NPI number?

The NPI number for Wyoming Medicine And Pharmacy LLC is 1104229426. It was assigned to this organization in the NPPES registry on October 1, 2014. The provider is doing business as Kentuckiana Medicine.

Where is Wyoming Medicine And Pharmacy LLC located?

Wyoming Medicine And Pharmacy LLC is located at 443 Spring St Suite 303, Jeffersonvlle, IN 47130. The listed phone number is (812) 913-4416.

What is Wyoming Medicine And Pharmacy LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Wyoming Medicine And Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2255310) is associated with this NPI, valid through March 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wyoming Medicine And Pharmacy LLC was last updated on October 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.