Individual provider Active NPI

Mehreen Mansoor, M.D

  • Child & Adolescent Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1093857955
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
42732 Issued in KY
Practice address
914 E Broadway
Louisville, KY 40204-1037
Phone
(502) 589-8600
Fax
(502) 589-8771
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 42732 KY Primary
Child & Adolescent Psychiatry Physician 2084P0804X 01073729A IN

Addresses

Primary practice location

914 E Broadway
Louisville, KY 40204-1037

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140627000345 IN Practitioner - Psychiatry 4688899008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespring, IncGroup PAC ID 5294624508, 65 clinicians

Practice addresses (Care Compare)

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 413-3117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42732KYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring, Inc CurrentSince Jun 2, 2014 Accepting new patients
Lifespring, Inc CurrentSince Jun 2, 2014 Accepting new patients

Locations

404 Spring St
Jeffersonville, IN 47130
Phone (812) 206-1303

460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583

1405 Bear St
Madison, IN 47250
Phone (812) 265-4513

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1093857955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041037",
            "telephone_number": "502-589-8600",
            "fax_number": "502-589-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "MEHREEN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "42732",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01073729A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.