Individual provider Active NPI

Vijay Menon, MD

  • Neonatal-Perinatal Medicine Physician
  • Elizabethtown, KY
National Provider Identifier
1124123633
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01056824 Issued in IN
Practice address
913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone
(270) 737-1212
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 55613 KY
Neonatal-Perinatal Medicine Physician 2080N0001X 01056824 IN Primary

Addresses

Primary practice location

913 N Dixie Ave
Elizabethtown, KY 42701-2503

Mailing address

504 Aintree Ave
Holly Springs, NC 27540-4987
Phone (317) 379-6341

Other identifiers 1

IdentifierTypeStateIssuer
200406490MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220126003138 IN Practitioner - Pediatric MedicinePractitioner - Other (Physician) 2062804933 Reassigns benefits to 3 organizations
I20240122004418 KY Practitioner - Pediatric Medicine 2062804933 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55613KYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Pediatrics CurrentSince Oct 21, 2023 Accepting new patients
Franciscan Physician Network CurrentSince Jan 14, 2022 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
The Methodist Hospitals, Inc CurrentSince Feb 1, 2023 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Oct 18, 2023 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Oct 18, 2023 Accepting new patients
Franciscan Physician Network CurrentSince Jan 14, 2022 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Feb 1, 2023 Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Current Accepting new patients

Locations

27350 Network Pl
Chicago, IL 60673

2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

1000 Breckenridge St
Ste 301
Owensboro, KY 42303
Phone (270) 852-8894

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Interoperability endpoints

  • Direct secure messaging: vijaymenon@nmhs.medalliesdirect.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1124123633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 AINTREE AVE",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275404987",
            "telephone_number": "317-379-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012503",
            "telephone_number": "270-737-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "VIJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "55613",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01056824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200406490",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.