NPIMap

Organization Active NPI

First Urology, PSC

  • Urology Physician
  • Louisville, KY
National Provider Identifier
1275208977
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
FIRST UROLOGY, PSC
Practice address
5120 Dixie Hwy Ste 105
Louisville, KY 40216-1775
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Aug 13, 2021
Last updated
Apr 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST UROLOGY, PSCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Michael J Shannon
Title
Ceo
Phone
(812) 282-3899

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Radiation Oncology Physician 2085R0001X NU
Diagnostic Radiology Physician 2085R0202X NU
Vascular & Interventional Radiology Physician 2085R0204X NU
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

5120 Dixie Hwy Ste 105
Louisville, KY 40216-1775

Mailing address

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

Other identifiers 3

IdentifierTypeStateIssuer
65906414MedicaidKY
78902830MedicaidKY
1650OtherKYMEDICARE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2232603First Urology, PSC5120 Dixie Hwy Ste 105, Louisville, KY 40216Provider-performed microscopyAug 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
First Urology PSC17 organizations share this tax ID, including this one
Part of
First Urology PSC

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

5120 Dixie Hwy
Ste 206
Louisville, KY 40216

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1275208977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 DIXIE HWY STE 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161775",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST UROLOGY, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST UROLOGY, PSC",
        "enumeration_date": "2021-08-13",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-282-3899"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65906414",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78902830",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1650",
            "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 Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.