Active NPI
George W Robertson, M.D.
- Obstetrics & Gynecology Physician
- Louisville, KY
National Provider Identifier
1194720342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 20738
- Practice address
- 4130 Dutchmans LN
Ste 400
Louisville, KY 40207-4711 - Phone
- (502) 897-0697
- Fax
- (502) 897-0658
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 20738 | KY | Primary |
Addresses
Primary practice location
4130 Dutchmans LN
Ste 400
Louisville, KY 40207-4711
Mailing address
4130 Dutchmans LN
Ste 400
Louisville, KY 40207-4711
Phone (502) 897-0697
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0700074 | Other | KY | UNITED HEALTHCARE |
| 160032460 | Other | KY | RAILROAD |
| 0406000000044471 | Other | KY | BLUE CROSS/BLUE SHIELD |
| 610673930G | Other | KY | HUMANA |
| EMPLOYER'S ID | Other | KY | 610673930 |
| 6420738400 | Medicaid | KY | |
| 1048738 | Other | KY | PASSPORT |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20738 | KY | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194720342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4130 DUTCHMANS LN",
"address_2": "STE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074711",
"telephone_number": "502-897-0697",
"fax_number": "502-897-0658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 DUTCHMANS LN",
"address_2": "STE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074711",
"telephone_number": "502-897-0697",
"fax_number": "502-897-0658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "GEORGE",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "KY",
"license": "20738",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0700074",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "160032460",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "0406000000044471",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "610673930G",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "610673930",
"identifier": "EMPLOYER'S ID",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6420738400",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "1048738",
"state": "KY"
}
],
"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 9, 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.