Individual provider Active NPI

Sean Thomas Beattie, DO

  • Neurology Physician
  • Louisville, KY
National Provider Identifier
1053940015
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
06094 Issued in KY
Practice address
4003 Kresge Way Ste 400
Louisville, KY 40207-4652
Phone
(502) 895-7265
Fax
(502) 897-2032
NPI assigned
Apr 2, 2020
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neurology Physician 2084N0400X 06094 KY Primary

Addresses

Primary practice location

4003 Kresge Way Ste 400
Louisville, KY 40207-4652

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 253-4924

Other practice location 1

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-5000

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
I20250707003572 KY Practitioner - Neurology 7517381627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

4003 Kresge Way
Suite 400
Louisville, KY 40207-4652
Phone (502) 895-4263

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06094KYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Neurology CurrentSince Jun 24, 2025 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 24, 2025 Accepting new patients
Baptist Healthcare System Inc. Past Accepting new patients

Locations

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

4003 Kresge Way
Ste 400
Louisville, KY 40207
Phone (502) 895-4263

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1053940015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-253-4924",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074652",
            "telephone_number": "502-895-7265",
            "fax_number": "502-897-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTIE",
        "first_name": "SEAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "06094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.