Individual provider Active NPI

Tracy Suzzanne Cohoon, M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1316073463
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42204 Issued in KY
Practice address
3950 Kresge Way
Suite 308
Louisville, KY 40207-4637
Phone
(502) 895-8911
Fax
(502) 895-8977
NPI assigned
Feb 25, 2007
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 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 42204 KY Primary

Addresses

Primary practice location

3950 Kresge Way
Suite 308
Louisville, KY 40207-4637

Mailing address

3950 Kresge Way
Suite 308
Louisville, KY 40207-4637
Phone (502) 895-8911

Other identifiers 3

IdentifierTypeStateIssuer
7100068690MedicaidKY
000000592728OtherKYBCBS
000000919568OtherKYANTHEM

Other names 1

  • Tracy Suzzanne Miller Former name

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081125000115 KY Practitioner - HospitalistPractitioner - Internal Medicine 8628138336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of South Alabama College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Hospitalist Associates PLLCGroup PAC ID 1456451715, 34 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 895-8911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42204KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1316073463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY",
            "address_2": "SUITE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-895-8911",
            "fax_number": "502-895-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY",
            "address_2": "SUITE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-895-8911",
            "fax_number": "502-895-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHOON",
        "first_name": "TRACY",
        "middle_name": "SUZZANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-25",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "42204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100068690",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000592728",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000919568",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MILLER",
            "middle_name": "SUZZANNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.