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Kendra Nadine Ivy

Internal Medicine

Allopathic & Osteopathic Physicians

530 S Jackson St, Louisville, KY 40202-1675

PECOS Enrollment

This provider is enrolled in PECOS as KENDRA IVY.

Based on the most recent information from CMS, provider Kendra Nadine Ivy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1336760768
Provider Type
Individual
Full Name
Ivy, Kendra Nadine
Credential
MD

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/27/2020
Last Updated
5/21/2024

Contact Information

Practice Location

530 S Jackson St, Louisville, KY 40202-1675

(502) 852-5689

Unlisted Fax

Mailing Location

PO Box 909, Louisville, KY 40201-0909

(502) 588-0330

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License TP161 Kentucky
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License TP161 Kentucky

Kendra Nadine Ivy

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Stivers, Ashley Marie

Augenstein, Abigail Claire

Meyer, Michael Steven

Brown, Julianna Rose

Rosario, Zahira

Goldberg, Sarah Sloan

Morris, Matthew D

Staley, Stella R.

Patel, Sahil

Louisville Medical Associates