# SHC MEDICAL PARTNERS OF KENTUCKY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SHC MEDICAL PARTNERS, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417132614
- **Legal business name:** SHC MEDICAL PARTNERS, LLC
- **Authorized official:** MRS. PENNY LOGAN (COO)
- **Authorized official phone:** (502) 558-2193

## Contact information

- **Practice address:** 2529 SIX MILE LN, LOUISVILLE, KY 40220
- **Practice address phone:** (502) 491-5560
- **Practice address fax:** (502) 491-0214
- **Mailing address:** 805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
- **Mailing address phone:** (502) 558-2193
- **Mailing address fax:** (502) 568-7121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | KY | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2008
- **Last updated:** 03/30/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100185200 | — | KY |
| 05 | — | 7100405980 | — | KY |