NPIMap

Organization Active NPI

Medicine PLLC

  • Infectious Disease Physician
  • Louisville, KY
National Provider Identifier
1003003351
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
MEDICINE PLLC
Practice address
15103 Chestnut Ridge Cir
Louisville, KY 40245-5291
Phone
(502) 742-9149
Fax
(502) 896-7292
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jawed Nasim, M.D.NPI 1871576702
Title
President
Phone
(502) 742-9149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

15103 Chestnut Ridge Cir
Louisville, KY 40245-5291

Mailing address

PO Box 890853
Charlotte, NC 28289-0853
Phone (800) 605-5176

Other identifiers 2

IdentifierTypeStateIssuer
200906410AMedicaidIN
6435287500MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071207000565 KY Part B Supplier - Clinic/Group Practice 1658460092 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

3910 S DuPont Sq
#A
Louisville, KY 40207
Phone (502) 814-3182

4445 Manslick Rd
Louisville, KY 40216
Phone (502) 361-6417

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1003003351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890853",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890853",
            "telephone_number": "800-605-5176",
            "fax_number": "937-298-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15103 CHESTNUT RIDGE CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455291",
            "telephone_number": "502-742-9149",
            "fax_number": "502-896-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "NASIM",
        "authorized_official_first_name": "JAWED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-742-9149",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200906410A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6435287500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.