Individual provider Active NPI

Kathrine Conliffe, D.O.

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1053606103
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
03688 Issued in KY
Practice address
506 Executive Park
Louisville, KY 40207-4205
Phone
(502) 822-6603
Fax
(502) 747-7071
NPI assigned
Jun 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 03688 KY Primary

Addresses

Primary practice location

506 Executive Park
Louisville, KY 40207-4205

Mailing address

506 Executive Park
Louisville, KY 40207-4205
Phone (502) 822-6603

Other identifiers 2

IdentifierTypeStateIssuer
300050353MedicaidIN
7100317450MedicaidKY

Other names 1

  • Kathrine Krantz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141106001303 KY Practitioner - Pediatric Medicine 4082842893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musculoskeletal Associates PLLCGroup PAC ID 8224328307, 5 clinicians

Practice addresses (Care Compare)

506 Executive Park
Louisville, KY 40207-4205
Phone (502) 822-6603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
03688KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Musculoskeletal Associates PLLC CurrentSince Jan 1, 2024 Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients

Locations

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

4010 DuPont Cir
Ste 283
Louisville, KY 40207
Phone (502) 897-1727

506 Executive Park
Louisville, KY 40207
Phone (502) 213-3807

Interoperability endpoints

  • Direct secure messaging: kconliffe76750@direct.nortonhealthcare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1053606103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074205",
            "telephone_number": "502-822-6603",
            "fax_number": "502-747-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074205",
            "telephone_number": "502-822-6603",
            "fax_number": "502-747-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLIFFE",
        "first_name": "KATHRINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "03688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300050353",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100317450",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRINE",
            "last_name": "KRANTZ",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.