NPIMap

Individual provider Active NPI

Christopher S. McClellan, MD

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1174588651
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34957 Issued in KY
Practice address
112 Sears Ave
Louisville, KY 40207-5014
Phone
(502) 238-2163
Fax
(502) 238-2173
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34957 KY Primary

Addresses

Primary practice location

112 Sears Ave
Louisville, KY 40207-5014

Mailing address

2425 Lime Kiln LN
Louisville, KY 40222-3462
Phone (502) 899-7163

Other identifiers 7

IdentifierTypeStateIssuer
000000225513OtherKYANTHEM / NCMA
110235213OtherKYRAILROAD MEDICARE
012817OtherKYSIHO / NCMA
000026447NOtherKYHUMANA / NCMA
2439608000OtherKYPASSPORT ADVANTAGE / NCMA
64046287MedicaidKY
200381960MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210001002 KY Practitioner - Internal Medicine 9830386242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onemd St Matthews PLLCGroup PAC ID 3072732429, 3 clinicians

Practice addresses (Care Compare)

112 Sears Ave
Louisville, KY 40207-5014
Phone (502) 238-2163

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Onemd St Matthews PLLC Internal Medicine CurrentSince Jul 20, 2014 Accepting new patients
Kentuckiana Emergency Physicians, PLLC Past Accepting new patients
Onemd-Louisville PLLC Internal Medicine PastSince Jul 20, 2014 Accepting new patients

Locations

2425 Lime Kiln Ln
Louisville, KY 40222
Phone (502) 899-7163

112 Sears Ave
Louisville, KY 40207
Phone (502) 238-2163

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1174588651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223462",
            "telephone_number": "502-899-7163",
            "fax_number": "502-897-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SEARS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075014",
            "telephone_number": "502-238-2163",
            "fax_number": "502-238-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM / NCMA",
            "identifier": "000000225513",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235213",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO / NCMA",
            "identifier": "012817",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA / NCMA",
            "identifier": "000026447N",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE / NCMA",
            "identifier": "2439608000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64046287",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200381960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.