Kentuckiana Gastroenterology PSC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

33458 Issued in KY

Legal business name

KENTUCKIANA GASTROENTEROLOGY PSC

Practice address

1003 N Dupont SQ # 9a
Louisville, KY 40207-4612

Phone

(502) 893-7744

Fax

(502) 893-7741

NPI assigned

Mar 19, 2008

Last updated

Mar 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anand Gupta, MDNPI 1841299138

Title

Owner

Phone

(502) 893-7744

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Tricounty Gastroenterology Former legal business name

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anand Gupta, MD, FACG

  • Gastroenterology Physician
  • Louisville, KY
  • NPI 1841299138

  IN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1336310135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N DUPONT SQ # 9A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-893-7744",
            "fax_number": "502-893-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 N DUPONT SQ # 9A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-893-7744",
            "fax_number": "502-893-7741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471306016",
            "country_code": "US",
            "telephone_number": "502-893-7744",
            "fax_number": "502-893-7741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENTUCKIANA GASTROENTEROLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ANAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-893-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "33458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64343585",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "24420293000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH",
            "identifier": "50015404",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tricounty Gastroenterology",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Tricounty Gastroenterology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.