Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Commonwealth of Kentucky

Organization Multi-Specialty Clinic/Center · NPI 1114346467

Commonwealth of Kentucky is a Multi-Specialty Clinic/Center in Louisville, Kentucky. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

1800 Bluegrass Ave
Louisville, KY 40215-1130
Phone: (502) 361-2301
Fax: (502) 366-0367
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X

Record details

NPI number1114346467
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCommonwealth of Kentucky
Authorized official Jennifer Moore — Assistant Director · (502) 782-6117
Other names Hazelwood Specialty Clinic; Hazelwood Specialty Clinic; Hazelwood Specialty Clinic
NPI enumeratedApril 15, 2014
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024
Mailing address1800 Bluegrass Ave, Louisville, KY 40215-1130

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