COMMUNITY CARE OF KENTUCKY, INC.
NPI 1811375785
Dentist - General Practice in Louisville, KY

Active since May 12, 2015
2500 W BROADWAY STE 100, LOUISVILLE, KY 40211(502) 776-1754(502) 778-2301 Get Directions Write a Review

NPPES record last updated: May 7, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 7, 2018, Jul 10, 2017 (2 updates tracked since 2017).

About Community Care Of Kentucky, Inc. NPPES

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

COMMUNITY CARE OF KENTUCKY, INC. (NPI 1811375785) is a healthcare organization registered as a general practice in Louisville, Kentucky and active in the NPI registry since May 2015. The organization lists Jenell Stump, Manager, Licensing & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1811375785
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCOMMUNITY CARE OF KENTUCKY, INC.
Location Address2500 W BROADWAY STE 100Louisville, KY 40211-1184
Mailing AddressPo Box 2369Anniston, AL 36202-2369 · (256) 241-3965 · Fax (256) 241-1698
Fax(502) 778-2301
Organization SubpartNo
Authorized OfficialJenell StumpManager, Licensing & Credentialing · (629) 999-5006
Enumeration DateMay 12, 2015
Last NPPES UpdateMay 7, 20182 updates tracked since enumeration
NPI 1811375785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2500 W BROADWAY STE 100, Louisville, KY 40211

Other Identifiers 1

Medicaid7100298140KY

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

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

Nurse Practitioner (Family)
2500 W BROADWAY STE 100
LOUISVILLE, KY 40211

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811375785, enumerated as an "organization" on May 12, 2015.

The provider is located at 2500 W BROADWAY STE 100 LOUISVILLE, KY 40211 and the phone number is (502) 776-1754.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.