NPIMap

Organization Active NPI

Louisville Endoscopy Center, PLLC

Doing business as Louisville Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Louisville, KY
National Provider Identifier
1003888595
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
300132 Issued in KY
Legal business name
LOUISVILLE ENDOSCOPY CENTER, PLLC
Doing business as
Louisville Endoscopy Center
Practice address
1400 Poplar Level Rd
Suite 2
Louisville, KY 40217-1309
Phone
(502) 636-2003
Fax
(502) 636-4032
NPI assigned
Feb 7, 2006
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
Mr. Jeffrey Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 300132 KY Primary

Addresses

Primary practice location

1400 Poplar Level Rd
Suite 2
Louisville, KY 40217-1309

Mailing address

1A Burton Hills Blvd
Attn: L&C
Nashville, TN 37215-6103
Phone (615) 665-1283

Other identifiers 4

IdentifierTypeStateIssuer
2437243000MedicaidKY
36001055MedicaidKY
2437243000OtherKYPASSPORT ADVANTAGE
200411570AMedicaidIN

Other names 1

  • Louisville Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050303000896 KY Part B Supplier - Ambulatory Surgical Center 0042264913 Practice locations: Louisville, KY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Louisville Endoscopy CenterCCN 18C0001029
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0974366Louisville Endoscopy Center PLLC1400 Poplar Level Road Suite Two, Louisville, KY 40217Certificate of waiverJun 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1003888595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "615-665-1283",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 POPLAR LEVEL RD",
            "address_2": "SUITE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171309",
            "telephone_number": "502-636-2003",
            "fax_number": "502-636-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE ENDOSCOPY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2437243000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001055",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2437243000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200411570A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisville Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Louisville Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.