Individual provider Active NPI

Michael V. Greenwell, MD

  • Gastroenterology Physician
  • Louisville, KY
National Provider Identifier
1104821735
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
24686 Issued in KY
Practice address
3950 Kresge Way
Ste 207
Louisville, KY 40207-4637
Phone
(502) 893-0220
Fax
(502) 893-0563
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 207RG0100X KY
Gastroenterology Physician 207RG0100X 24686 KY Primary

Addresses

Primary practice location

3950 Kresge Way
Ste 207
Louisville, KY 40207-4637

Mailing address

PO Box 950296
Louisville, KY 40295-0296
Phone (502) 893-0220

Other identifiers 1

IdentifierTypeStateIssuer
64246861MedicaidKY

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
I20110323000610 KY Practitioner - Gastroenterology 7012190366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Louisville School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

3950 Kresge Way
Suite 207
Louisville, KY 40207-4637
Phone (502) 893-0220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy116
Upper gastrointestinal (GI) endoscopy for acid reflux90

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207RG0100XKYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Gastroenterology Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 22, 2012 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 22, 2012 Accepting new patients

Locations

1023 New Moody Ln
Ste 10
La Grange, KY 40031
Phone (502) 222-6008

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

3950 Kresge Way
Ste 207
Louisville, KY 40207
Phone (502) 893-0220

Interoperability endpoints

  • Direct secure messaging: mgreenwell6978@bhkydirect.com

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1104821735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950296",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950296",
            "telephone_number": "502-893-0220",
            "fax_number": "502-893-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY",
            "address_2": "STE 207",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-893-0220",
            "fax_number": "502-893-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWELL",
        "first_name": "MICHAEL",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "207RG0100X",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "24686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64246861",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.