NPIMap

Individual provider Active NPI

James Gerard O'Brien, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Louisville, KY
National Provider Identifier
1063463917
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
32582 Issued in KY
Practice address
215 Central Ave
110
Louisville, KY 40208-1449
Phone
(502) 852-5205
Fax
(502) 852-5405
NPI assigned
May 15, 2006
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32582 KY
Geriatric Medicine (Family Medicine) Physician 207QG0300X 32582 KY Primary

Addresses

Primary practice location

215 Central Ave
110
Louisville, KY 40208-1449

Mailing address

501 E Broadway
Suite 290
Louisville, KY 40202-1785
Phone (502) 217-8221

Other identifiers 2

IdentifierTypeStateIssuer
64325822MedicaidKY
200113250MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Practice Assoc. PSC Family Medicine Past Accepting new patients
University Family & Geriatric Medicine Associates Inc Family Medicine PastSince May 1, 2008 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1063463917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY",
            "address_2": "SUITE 290",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021785",
            "telephone_number": "502-217-8221",
            "fax_number": "502-217-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CENTRAL AVE",
            "address_2": "110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402081449",
            "telephone_number": "502-852-5205",
            "fax_number": "502-852-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JAMES",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "32582",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "KY",
            "license": "32582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64325822",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200113250",
            "state": "IN"
        }
    ],
    "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 Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.