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WELLSPACE PSYCHIATRY
NPI 1710694468
Nurse Practitioner - Psychiatric/Mental Health in Louisville, KY

Active since November 02, 2022
9700 PARK PLAZA AVE UNIT 210, LOUISVILLE, KY 40241(502) 419-4289 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 25, 2023, Jul 14, 2023, Mar 7, 2023 and 2 more (5 updates tracked since 2022).

About Wellspace Psychiatry NPPES

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

WELLSPACE PSYCHIATRY (NPI 1710694468) is a healthcare organization registered as a psychiatric/mental health in Louisville, Kentucky and active in the NPI registry since November 2022. The organization lists Thomas J Federer, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1710694468
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameWELLSPACE PSYCHIATRY LLC
Location Address9700 PARK PLAZA AVE UNIT 210Louisville, KY 40241-2287
Mailing Address9700 Park Plaza Ave Unit 210Louisville, KY 40241-2287 · (502) 419-4289
Phone(502) 419-4289
Organization SubpartNo
Authorized OfficialThomas J FedererOwner/administrator · (502) 419-4289
Enumeration DateNovember 2, 2022
Last NPPES UpdateJuly 25, 20235 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2023
✔ NPI 1710694468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
9700 PARK PLAZA AVE UNIT 210, Louisville, KY 40241
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Other Names 1

Doing Business AsWellspace Psychiatry

Other Identifiers 4

Other1730733783Npi 1
Other3013601KY · Aprn License
Medicaid7100639170KY
Other1128009KY · Rn License

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellspace Psychiatry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wellspace Psychiatry, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Bush, PMHNP
Nurse Practitioner
NPI 1730733783
2355 SARATOGA DR
Louisville, KY 40205
(210) 287-0010
✔ PECOS✔ Accepts Medicare9.1 mi

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 Wellspace Psychiatry LLC's NPI number?

The NPI number for Wellspace Psychiatry LLC is 1710694468. It was assigned to this organization in the NPPES registry on November 2, 2022. The provider is doing business as Wellspace Psychiatry.

Where is Wellspace Psychiatry LLC located?

Wellspace Psychiatry LLC is located at 9700 Park Plaza Ave Unit 210, Louisville, KY 40241. The listed phone number is (502) 419-4289.

What is Wellspace Psychiatry LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Wellspace Psychiatry LLC enrolled in Medicare?

Yes. Wellspace Psychiatry LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wellspace Psychiatry LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Wellspace Psychiatry LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wellspace Psychiatry LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Wellspace Psychiatry LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wellspace Psychiatry LLC was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.