Individual provider Active NPI

Marvi M Buridi, MD

  • Student in an Organized Health Care Education/Training Program
  • Louisville, KY
National Provider Identifier
1336888106
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
60902 Issued in KY
Practice address
200 E Chestnut St FL 2
Louisville, KY 40202-1831
Phone
(502) 588-0800
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4351049598 MI
Child & Adolescent Psychiatry Physician 2084P0804X 60902 KY
Student in an Organized Health Care Education/Training Program 390200000X 60902 KY Primary

Addresses

Primary practice location

200 E Chestnut St FL 2
Louisville, KY 40202-1831

Mailing address

200 E Chestnut St FL 2
Louisville, KY 40202-1831
Phone (609) 576-9267

Other practice location 1

1000 Houghton Ave
Saginaw, MI 48602-5303
Phone (989) 746-7611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60902KYMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: marvi.memon.1@27771.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1336888106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST FL 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "609-576-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST FL 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-588-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Houghton Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025303",
            "country_code": "US",
            "telephone_number": "989-746-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURIDI",
        "first_name": "MARVI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4351049598",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "60902",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "60902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.