Douglas Owen Peeno, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

19315 Issued in KY

Practice address

3999 Dutchmans LN
Suite 4D
Louisville, KY 40207-4729

Phone

(502) 893-6777

Fax

(502) 899-5535

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Louisville OB GYN PSC

  • Obstetrics & Gynecology Physician
  • Louisville, KY
  • NPI 1346394723
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1265446256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY",
            "address_2": "STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4917",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN",
            "address_2": "SUITE 4D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074729",
            "telephone_number": "502-893-6777",
            "fax_number": "502-899-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEENO",
        "first_name": "DOUGLAS",
        "middle_name": "OWEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "19315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2623",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1051305",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64193154",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatrics With Care
• Pediatris Associates of Louisville, P.S.C.
• Michael Pedigo, LPCC
• Meagan Lee Peek, MD
• Rachel Peel, PT, DPT
• Tereza J Peercy, APRN
• Angela L Peevey, APRN
• Shapell Pegram
• Landen Pehle, DO
• Ted Deon Pekrins

• Gynecology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.