Ian Spencer Mutchnick, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

43020 Issued in KY

Practice address

210 E Gray St
Suite 1102
Louisville, KY 40202-3900

Phone

(502) 583-1697

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762
  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Orthopaedic Surgery of the Spine Physician
  • Louisville, KY
  • NPI 1437382074
  NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Norton Children'S Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Louisville, KY
  • NPI 1134760796

  Neurological Surgery

  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255
  NPD (past)
• Norton Hospitals, Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1891799227
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1295954386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST",
            "address_2": "SUITE 1102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023900",
            "telephone_number": "502-583-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCHNICK",
        "first_name": "IAN",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "095567",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "KY",
            "license": "43020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY",
            "identifier": "3746249000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY",
            "identifier": "50026300",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INDIANA MEDICAID- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY",
            "identifier": "200967320",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200967320",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100090630",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY",
            "identifier": "000000642043",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "108520",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY",
            "identifier": "3810329",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imutchnick11207@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "210 E Gray St",
            "address_2": "Suite 1102",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402023900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "210 E Gray St",
            "address_2": "Suite 1102",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402023900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Andrew Mussell, MD, MBA, MS
• Alexander Musser
• Grace Dougherty Mussetter, DPT
• Muhammad Talha Mustafa
• Marisa Musto
• Katherine Jean Muterspaw, DO
• Carol L Muth, D.M.D.
• Catherine Ann Muth, ARNP
• Carrie Mutter
• Jessica Mutters-Morales, DO

• Neurological Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neurological Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.