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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
Phone(502) 776-1754
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
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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.

GLADSTONE MOBILE HEALTHCARE LLC
Nurse Practitioner (Family)
2500 W BROADWAY STE 100
LOUISVILLE, KY 40211
Jefferson County (502) 888-9181

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 Community Care Of Kentucky, Inc.'s NPI number?

The NPI number for Community Care Of Kentucky, Inc. is 1811375785. It was assigned to this organization in the NPPES registry on May 12, 2015.

Where is Community Care Of Kentucky, Inc. located?

Community Care Of Kentucky, Inc. is located at 2500 W Broadway Ste 100, Louisville, KY 40211. The listed phone number is (502) 776-1754.

What is Community Care Of Kentucky, Inc.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Community Care Of Kentucky, Inc. was last updated on May 7, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.