Basic Information
| Provider Information | |||||||||
| NPI: | 1124072657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOMBARDI | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E LIBERTY ST STE 800 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023673360 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 1850 BLUEGRASS AVE | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402151161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023673360 | ||||||||
| FaxNumber: | 5023673365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 03/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 33680 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000722071 | 01 | KY | ANTHEM-CMA AUD.WEST | OTHER | 000057120B | 01 | KY | HUMANA-CMA AUD.WEST | OTHER | 6322876 | 01 | KY | CIGNA-CMA AUD.WEST | OTHER | 50033198 | 01 | KY | PASSPORT- CMA AUD. WEST | OTHER | 200437790 | 01 | IN | IN MEDICAID- CMA -AUDUBON WEST | OTHER | 64336803 | 05 | KY | MEDICAID | K002080 | 01 | KY | MEDICARE PTAN/ CMA AUD.WEST | OTHER | 125854 | 01 | KY | SIHO-CMA AUD.WEST | OTHER |