Individual provider Active NPI

Ryan William Smith

  • Neonatal-Perinatal Medicine Physician
  • Louisville, KY
National Provider Identifier
1386968832
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
45990 Issued in KY
Practice address
4123 Dutchmans LN
Suite 301
Louisville, KY 40207-4707
Phone
(502) 896-2500
Fax
(502) 896-2527
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X 45990 KY Primary
Pediatrics Physician 208000000X 45990 KY

Addresses

Primary practice location

4123 Dutchmans LN
Suite 301
Louisville, KY 40207-4707

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160120002468 KY Practitioner - Pediatric Medicine 0345543666 Reassigns benefits to 2 organizations
I20200330002163 IN Practitioner - Pediatric Medicine 0345543666 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45990KYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Pediatrics CurrentSince Mar 1, 2016 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Current Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2016 Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

4123 Dutchmans Ln
Ste 606
Louisville, KY 40207
Phone (502) 896-2500

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

4123 Dutchmans Ln
Ste 301
Louisville, KY 40207
Phone (502) 896-2500

Interoperability endpoints

  • Direct secure messaging: rsmith43552@direct.nortonhealthcare.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1386968832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "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": "4123 DUTCHMANS LN",
            "address_2": "SUITE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074707",
            "telephone_number": "502-896-2500",
            "fax_number": "502-896-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "45990",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "45990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.