Individual provider Active NPI

Justin M Doub, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1215070065
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5061 Issued in KY
Practice address
401 E Chestnut St Unit 610
Louisville, KY 40202-5711
Phone
(502) 588-4450
Fax
(502) 588-9539
NPI assigned
Feb 14, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5061 KY Primary

Addresses

Primary practice location

401 E Chestnut St Unit 610
Louisville, KY 40202-5711

Mailing address

401 E Chestnut St Unit 600
Louisville, KY 40202-5705
Phone (502) 588-4425

Other identifiers 1

IdentifierTypeStateIssuer
30605018MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621002917 KY Practitioner - Clinical Social Worker 1951679653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Suite 610
Louisville, KY 40202-5711
Phone (502) 813-6600

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5061KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jul 1, 2017 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 1, 2017 Accepting new patients
University Psychiatric Foundation, Inc. Clinical PastSince Jul 24, 2022 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 610
Louisville, KY 40202
Phone (502) 588-4450

401 E Chestnut St
Unit 600
Louisville, KY 40202
Phone (502) 588-4425

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 4

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215070065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 600",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025705",
            "telephone_number": "502-588-4425",
            "fax_number": "502-588-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 610",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025711",
            "telephone_number": "502-588-4450",
            "fax_number": "502-588-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUB",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30605018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.