Individual provider Active NPI

Mary Lynn Barresi, DO

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1255485256
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02573 Issued in KY
Practice address
825 S 6TH St
Louisville, KY 40203-2123
Phone
(502) 561-7000
Fax
(502) 568-1015
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 02573 KY Primary

Addresses

Primary practice location

825 S 6TH St
Louisville, KY 40203-2123

Mailing address

825 S 6TH St
Louisville, KY 40203-2123
Phone (502) 561-7000

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02573KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarion Health and Wellness LLC Past Accepting new patients
First Stop Urgent Care Center PSC Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1255485256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S 6TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032123",
            "telephone_number": "502-561-7000",
            "fax_number": "502-568-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S 6TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032123",
            "telephone_number": "502-561-7000",
            "fax_number": "502-568-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRESI",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "02573",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 4, 2021; 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.