NPIMap

Individual provider Active NPI

Samuel Clellen

  • Podiatrist
  • Louisville, KY
National Provider Identifier
1124607585
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
298939 Issued in KY
Practice address
3 Audubon Plaza Dr Ste 320
Louisville, KY 40217-1319
Phone
(502) 893-1844
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 298939 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Dr Ste 320
Louisville, KY 40217-1319

Mailing address

3 Audubon Plaza Dr Ste 320
Louisville, KY 40217-1319
Phone (502) 893-1844

Other practice location 1

1802 Allison Ln
Jeffersonville, IN 47130-5809
Phone (502) 893-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250725003939 IN Practitioner - Podiatry 6103368857 Reassigns benefits to 1 organization
I20250801002362 KY Practitioner - Podiatry 6103368857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, shared by 19 NPIs, 339 clinicians
University Foot and Ankle Center LLCGroup PAC ID 4284726514, 6 clinicians

Practice addresses (Care Compare)

12613 Taylorsville Rd
Louisville, KY 40299-5496
Phone (502) 267-1480

1802 Allison LN
Jeffersonville, IN 47130-5809
Phone (502) 893-1844

3 Audubon Plaza Dr
Suite 320
Louisville, KY 40217-1319
Phone (502) 893-1844

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue43
Removal of skin lesions21
Removal of nail tissue137
Removal or shaving of skin growth21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Foot and Ankle Center LLC Podiatrist CurrentSince Jul 1, 2025 Accepting new patients
University Foot and Ankle Center LLC Podiatrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

1263 Hospital Dr NW
Ste 100
Corydon, IN 47112
Phone (502) 888-1988

1802 Allison Ln
Jeffersonville, IN 47130
Phone (502) 893-1844

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

3 Audubon Plaza Dr
Ste 320
Louisville, KY 40217
Phone (502) 893-1844

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1124607585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR STE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171319",
            "telephone_number": "502-893-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR STE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171319",
            "telephone_number": "502-893-1844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Allison Ln",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471305809",
            "country_code": "US",
            "telephone_number": "502-893-1844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLELLEN",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "298939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.