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

Pearl Medical Practice PLLC

Organization Geriatric Medicine (Family Medicine) Physician · NPI 1114261203

Pearl Medical Practice PLLC is a Geriatric Medicine (Family Medicine) Physician in Louisville, Kentucky. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
5
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4200 Gardiner View Ave Ste 200
Louisville, KY 40213-1877
Phone: (502) 456-0494
Fax: (502) 456-0496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X
Physician Assistant Taxonomy 363A00000X
Adult Health Nurse Practitioner Taxonomy 363LA2200X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1114261203
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Osawaru Omoruyi — President · (502) 456-0494
NPI enumeratedNovember 15, 2012
Last updated in NPPESOctober 2, 2015
Mailing address4200 Gardiner View Ave, Suite 200, Louisville, KY 40213-1877

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