NPIMap

Organization Active NPI

Kentuckiana Ear, Nose & Throat PSC

  • Otolaryngology Physician
  • Louisville, KY
National Provider Identifier
1194771592
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
KENTUCKIANA EAR, NOSE & THROAT PSC
Practice address
6420 Dutchmans Pkwy Ste 380
Louisville, KY 40205-3355
Phone
(502) 894-8441
Fax
(502) 371-0929
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Authorized official

Name
Bruce Scott, MD
Title
President
Phone
(812) 283-8770

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary
Otolaryngic Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0602X
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0905X
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6420 Dutchmans Pkwy Ste 380
Louisville, KY 40205-3355

Mailing address

6420 Dutchmans Pkwy Ste 380
Louisville, KY 40205-3355
Phone (502) 894-8441

Other identifiers 3

IdentifierTypeStateIssuer
100001400MedicaidIN
65902710MedicaidKY
000000057516OtherKYANTHEM KY GP NUMBER

National Provider Directory

National Provider Directory

Locations

1405 Spring St
Jeffersonvlle, IN 47130
Phone (502) 894-8441

9850 Von Allmen Ct
Ste 104
Louisville, KY 40241
Phone (502) 894-8441

111 E Kentucky St
Louisville, KY 40203
Phone (502) 371-9910

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1194771592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 DUTCHMANS PKWY STE 380",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053355",
            "telephone_number": "502-894-8441",
            "fax_number": "502-371-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 DUTCHMANS PKWY STE 380",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053355",
            "telephone_number": "502-894-8441",
            "fax_number": "502-371-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA EAR, NOSE & THROAT PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-283-8770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001400",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65902710",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM KY GP NUMBER",
            "identifier": "000000057516",
            "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 Feb 16, 2018; 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.