Susan Raghavan, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

34555 Issued in KY

Legal business name

SUSAN RAGHAVAN, MD

Doing business as

Childrens Diabetes and Endocrinology

Practice address

9720 Park Plaza Ave Unit 202
Louisville, KY 40241-2290

Phone

(502) 327-9703

Fax

(502) 327-9798

NPI assigned

Sep 26, 2013

Last updated

Sep 26, 2013By 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

Susie Minsterketter

Title

Billing Dept

Phone

(502) 327-9703

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Childrens Diabetes and Endocrinology Doing business as

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.

• Susan Raghavan, MD

  • Pediatric Endocrinology Physician
  • Louisville, KY
  • NPI 1780737510
  NPD (past)

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1386070019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 PARK PLAZA AVE UNIT 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412290",
            "telephone_number": "502-327-9703",
            "fax_number": "502-327-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 PARK PLAZA AVE UNIT 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412290",
            "telephone_number": "502-327-9703",
            "fax_number": "502-327-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN RAGHAVAN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "MINSTERKETTER",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "BILLING DEPT",
        "authorized_official_telephone_number": "502-327-9703"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "KY",
            "license": "34555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC ENDOCRINOLOGY",
            "identifier": "2080P0205X",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64880008",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Diabetes and Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Surya Dental PSC (Parkway Family Dental)
• Surya Mental Wellness LLC
• Susan B Tate MD PA
• Susan B Tate MD PSC
• Susan E. Janocik M.D., PLLC
• Alexa Suter
• Shannon Ward Suter, MS,OTR/L, CLT
• Curtis James Sutera
• Carl C Sutherland, RPH
• Jennie B Sutherland

• Pediatric Endocrinology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Endocrinology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.