Individual provider Active NPI

Edwin M Ahrens, MD

  • Dermatology Physician
  • Louisville, KY
National Provider Identifier
1104829381
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
22183 Issued in KY
Practice address
310 E Broadway
Ste 100
Louisville, KY 40202-1745
Phone
(502) 585-5249
Fax
(502) 585-5251
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22183KYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Have a Heart Foundation Inc CurrentSince Jan 1, 2019 Accepting new patients

Locations

310 E Broadway
Ste 100
Louisville, KY 40202
Phone (502) 245-0002

310 E Broadway
Ste 200
Louisville, KY 40202
Phone (502) 585-5249

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 22183 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

310 E Broadway
Ste 100
Louisville, KY 40202-1745

Mailing address

310 E Broadway
Ste 100
Louisville, KY 40202-1745
Phone (502) 585-5249

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 16, 2007.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1104829381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249",
            "fax_number": "502-585-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249",
            "fax_number": "502-585-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHRENS",
        "first_name": "EDWIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "22183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.