NPIMap

Individual provider Active NPI

Amy M Deeley, MD

  • Obstetrics & Gynecology Physician
  • Louisville, KY
National Provider Identifier
1215911219
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33789 Issued in KY
Practice address
4121 Dutchmans Lane
Suite 601
Louisville, KY 40207
Phone
(502) 895-6559
Fax
(502) 895-8994
NPI assigned
Dec 2, 2005
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33789 KY Primary

Addresses

Primary practice location

4121 Dutchmans Lane
Suite 601
Louisville, KY 40207

Mailing address

4121 Dutchmans Lane
Suite 601
Louisville, KY 40207
Phone (502) 895-6559

Other identifiers 4

IdentifierTypeStateIssuer
1103823MedicaidKY
160037926OtherKYRR MEDICARE
610679864FOtherKYHUMANA
000000044686OtherKYBCBS

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
I20101004000903 KY Practitioner - Obstetrics/Gynecology 2163614561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kentucky College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Women OB/GYN, PSCGroup PAC ID 2769455781, 5 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite L07
Louisville, KY 40207-4812
Phone 5028956559205

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33789KYMDObstetrics & Gynecology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1215911219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 DUTCHMANS LANE",
            "address_2": "SUITE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 DUTCHMANS LANE",
            "address_2": "SUITE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEELEY",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "33789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1103823",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "160037926",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "610679864F",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000044686",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.