NPIMap

Individual provider Active NPI

Mary Shea O'Brien, MD

  • Obstetrics & Gynecology Physician
  • Louisville, KY
National Provider Identifier
1083118863
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
TP346 Issued in KY
Practice address
4123 Dutchmans LN Ste 500
Louisville, KY 40207-4730
Phone
(502) 894-9494
Fax
(502) 894-9404
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X TP346 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4123 Dutchmans LN Ste 500
Louisville, KY 40207-4730

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

550 S Jackson St Fl St2
Louisville, KY 40202-1622
Phone (502) 561-7448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906003451 KY Practitioner - Obstetrics/Gynecology 5799225579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4123 Dutchmans LN
Suite 500
Louisville, KY 40207-4730
Phone (502) 894-9494

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP346KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

106 W John Rowan Blvd
Ste E
Bardstown, KY 40004
Phone (502) 350-4799

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4123 Dutchmans Ln
Ste 500
Louisville, KY 40207
Phone (502) 894-9494

4123 Dutchmans Ln
Ste 515
Louisville, KY 40207
Phone (502) 899-6900

Organizations & group practices 4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1083118863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN STE 500",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074730",
            "telephone_number": "502-894-9494",
            "fax_number": "502-894-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Jackson St Fl St2",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021622",
            "country_code": "US",
            "telephone_number": "502-561-7448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARY",
        "middle_name": "SHEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "TP346",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.