DERBY CITY MEDICAL PARTNERS LLC NPI 1811572530

NPI Information

  • NPI: 1811572530
  • Provider Name: DERBY CITY MEDICAL PARTNERS, LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 18D2188171
  • Address: 1151 S 4TH ST STE 206
    LOUISVILLE, KY
    ZIP 40203
  • Phone: (502) 808-1048

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NPI Details

DERBY CITY MEDICAL PARTNERS, LLC is a family nurse practitioner in Louisville, KY. DERBY CITY MEDICAL PARTNERS, LLC NPI is 1811572530. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1151 S 4TH ST STE 206
LOUISVILLE, KY
ZIP 40203
Phone: (502) 808-1048
Fax: (888) 910-5166

The provider's authorized official is Latonya Banks .
The authorized official title is Owner/provider Aprn and has the following contact phone number (502) 302-9241.

The CLIA number assigned to this NPI record is 18D2188171 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/15/2021 and was last updated on 5/5/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100733400MEDICAIDKENTUCKY
27100624280MEDICAIDKENTUCKY
37100613820MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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