KIOSK MEDICINE OF KENTUCKY LLC
NPI 1407249717
Nurse Practitioner - Family in Louisville, KY

Q: What is Kiosk Medicine Of Kentucky LLC's NPI number?

The NPI number for Kiosk Medicine Of Kentucky LLC is 1407249717. It was assigned to this organization in the NPPES registry on March 11, 2015.

Q: What is Kiosk Medicine Of Kentucky LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since March 11, 2015CLIA 18D2057675 · Waiver

5001 MUD LN, LOUISVILLE, KY 40229(502) 962-0710(502) 962-0711 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2025, Dec 12, 2024, Dec 21, 2016 (3 updates tracked since 2016).

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About Kiosk Medicine Of Kentucky Llc NPPES

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

KIOSK MEDICINE OF KENTUCKY LLC (NPI 1407249717) is a healthcare organization registered as a family in Louisville, Kentucky and active in the NPI registry since March 2015. The organization holds a CLIA Waiver certificate valid through April 21, 2027 and lists Thomas Shelly, Vp & General Manager, as its authorized official.

NPPES Registry Identity

NPI1407249717

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameKIOSK MEDICINE OF KENTUCKY LLC

Location Address5001 MUD LNLouisville, KY 40229-2870

Mailing Address2620 Elm Hill PikeNashville, TN 37214-3108 · (615) 425-4200

Phone(502) 962-0710

Fax(502) 962-0711

Organization SubpartNo

Authorized OfficialThomas ShellyVp & General Manager · (615) 425-4200

Enumeration DateMarch 11, 2015

Last NPPES UpdateOctober 21, 20253 updates tracked since enumeration

NPPES CertifiedOctober 21, 2025

✔ NPI 1407249717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Also ListedPhysician AssistantTaxonomy 363A00000X

5001 MUD LN, Louisville, KY 40229

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Other Identifiers 1

Medicaid7100350810KY

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

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 18D2057675

Kiosk Medicine Of Kentucky, LLC · Louisville, KY

Active · expires Apr 21, 2027

CLIA Number18D2057675

Laboratory TypeWalk In Healthcare Clinic

Certificate Effective DateApril 22, 2025

Certificate Expiration DateApril 21, 2027

Laboratory DirectorErin Macy

Laboratory Phone(502) 962-0710

Laboratory LocationKiosk Medicine Of Kentucky, LLC5001 Mud Lane, Louisville, KY 40229

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

JANNA R. SHARP APRN

Nurse Practitioner (Family)