Jean Marie Kallis, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

31457 Issued in KY

Practice address

231 E Chestnut St
Louisville, KY 40202-1821

Phone

(502) 629-6000

Fax

(502) 629-5991

NPI assigned

Jan 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jean Marie Ogburn Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316

  Pediatrics

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Louisville, KY
  • NPI 1487292033
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• University of Louisville Physicians, Inc.

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• University of Louisville Physicians, Inc.

  • Pediatric Gastroenterology Physician
  • Louisville, KY
  • NPI 1598021222
  NPD

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1083685317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "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": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-6000",
            "fax_number": "502-629-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLIS",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "31457",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "KY",
            "license": "31457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64937543",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200012490",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "OGBURN",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsay Skye Kalick, DO
• Jacie R Kalk, APSS, TCM, CSA
• John Charles Kall, DMD
• Rachael Marie Kallembach
• Kirstyn Kallick, MS, OTR
• Kallykare LLC
• Dinesh K Kalra, MD
• Saygin Kamaci, M.D.
• Kamal K. Nigam MD Internal Medicine, PLLC
• Palwasha Kamal, MD

• Pediatric Emergency Medicine (Pediatrics) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.