Organization · NPI-2
2022 LLC
Nurse Practitioner, Family · Louisville, KY
NPI number1821809153
StatusActive
Last updated in NPPESOct 3, 2025
Details
- NPI
- 1821809153
- Entity type
- Organization (NPI-2)
- Legal business name
- 2022 LLC
- Organization subpart
- Yes
- Enumeration date
- Jan 16, 2025
- Certification date
- Oct 3, 2025
- Last updated
- Oct 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Other names
- Dba Arch Medical Center (Other Name)
Practice location
700 Gagel AveLouisville, KY 40216-4008
Phone 502-963-5516 · Fax 502-963-5704
Mailing address
4104 Smarty Jones DrLouisville, KY 40214-6530
Phone 502-759-6281 · Fax 502-772-1533
Authorized official
Xavier Giles
Owner
5023840939
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