Individual provider Active NPI

Ajith Nair, MD

  • Specialist
  • Louisville, KY
National Provider Identifier
1073515227
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36217 Issued in KY
Practice address
3710 Chamberlain LN
Ste a
Louisville, KY 40241
Phone
(502) 995-4004
Fax
(502) 933-5559
NPI assigned
Jun 1, 2005
Last updated
Jul 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 36217 KY Primary

Addresses

Primary practice location

3710 Chamberlain LN
Ste a
Louisville, KY 40241

Mailing address

PO Box 24261
Louisville, KY 40224-0261
Phone (502) 995-4004

Other identifiers 2

IdentifierTypeStateIssuer
1073515227OtherKYMEDICARE NPI
64024896MedicaidKY

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
I20031111000271 KY Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 8820901341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3710 Chamberlain LN
Suite a
Louisville, KY 40241-2002
Phone (502) 995-4004

PO Box
Suite 24261
Louisville, KY 40224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36217KYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Control Network, PSC Past Accepting new patients
PCN Surgical Suites, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ajith.nair@3547.securemail.prognocis.com
  • Direct secure messaging: ajith.nair@3548.securemail.prognocis.com

Organizations & group practices 7

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1073515227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24261",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402240261",
            "telephone_number": "502-995-4004",
            "fax_number": "502-933-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 CHAMBERLAIN LN",
            "address_2": "STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-995-4004",
            "fax_number": "502-933-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "AJITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "36217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1073515227",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64024896",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.