HAZELWOOD SPECIALTY CLINIC
NPI 1114346467
Clinic/Center - Multi-Specialty in Louisville, KY
About Hazelwood Specialty Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HAZELWOOD SPECIALTY CLINIC (NPI 1114346467) is a healthcare organization registered as a multi-specialty in Louisville, Kentucky and active in the NPI registry since April 2014. The organization lists Jennifer Moore, Assistant Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Hazelwood Specialty Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
19Medicare enrollment records show 19 clinicians reassign Medicare billing to Hazelwood Specialty Clinic, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 15 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 12
Clinicians, nearest first (19)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Commonwealth Of Kentucky's NPI number?
The NPI number for Commonwealth Of Kentucky is 1114346467. It was assigned to this organization in the NPPES registry on April 15, 2014. The provider is also known as Hazelwood Specialty Clinic.
Where is Commonwealth Of Kentucky located?
Commonwealth Of Kentucky is located at 1800 Bluegrass Ave, Louisville, KY 40215. The listed phone number is (502) 361-2301.
What is Commonwealth Of Kentucky's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Commonwealth Of Kentucky enrolled in Medicare?
Yes. Commonwealth Of Kentucky is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Commonwealth Of Kentucky?
According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 12 Medicare specialties reassign their Medicare billing to Commonwealth Of Kentucky. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (7), Psychiatry (2) and Clinical Psychologist (1). Of these, 5 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Commonwealth Of Kentucky was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Hazelwood Specialty Clinic · NPI 1114346467
Multi-Specialty organization in Louisville, Kentucky. Organization record, active in the CMS NPPES registry since April 15, 2014.
## Identity
- **NPI:** 1114346467 (Entity type: Organization)
- **Enumerated:** April 15, 2014
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Legal business name:** Commonwealth Of Kentucky
- **Organization subpart:** Yes (part of Commonwealth Of Kentucky)
- **Authorized official:** Jennifer Moore, ASSISTANT DIRECTOR
## Practice location
- **Address:** 1800 BLUEGRASS AVE, Louisville, KY 40215-1130
- **Phone:** (502) 361-2301 · **Fax:** (502) 366-0367
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 19 clinicians in 12 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Psychiatry (2), Clinical Psychologist (1); 5 practice at this address and 15 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1114346467) · Data from the CMS NPPES public registry.