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Organization

GASTROENTEROLOGY HEALTH PARTNERS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINA MATERNA (DIRECTOR, CREDENTIALING)
(901) 377-8219
Entity
Organization

Contact information

Practice address
1941 BISHOP LN, STE 200, LOUSIVILLE, KY 40218
(502) 888-1988
(502) 452-6577
Mailing address
ONE GI CREDENTIALING DEPARTMENT, PO BOX 381468, GERMANTOWN, TN 38183-1468
(901) 328-1355

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
261QM1300X
Multi-Specialty Clinic/Center
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201161010A
IN
05
300022756
IN
05
300074837
IN
05
300115647
IN
05
300118093
IN
05
300119324
IN
05
300119328
IN
05
7100236330
KY
05
7100371700
KY
05
7100473430
KY
05
7100477300
KY
05
7100505380
KY
Enumeration date
05/11/2012
Last updated
02/03/2026
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