NPIMap

Individual provider Active NPI

Otis Christopher Colvin, M.D.

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1396708244
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44977 Issued in KY
Practice address
530 S Jackson St Ste C07
Louisville, KY 40202-1675
Phone
(502) 852-5875
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35-126232 OH
Diagnostic Radiology Physician 2085R0202X 44977 KY Primary

Addresses

Primary practice location

530 S Jackson St Ste C07
Louisville, KY 40202-1675

Mailing address

PO Box 909
Louisville, KY 40201-0909

Other identifiers 4

IdentifierTypeStateIssuer
0134089MedicaidOH
820183MedicaidAZ
201136370MedicaidIN
7100135110MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130213000304 KY Practitioner - Diagnostic Radiology 7911179544 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisville Medical College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Ray Associates of Louisville PSCGroup PAC ID 9436146818, 55 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8121

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040
  • University of Louisville Hospital Hospital, Louisville, KY, CCN 180141
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44977KYMDDiagnostic Radiology Physician
35-126232OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates Inc Diagnostic Radiology CurrentSince Apr 3, 2022 Accepting new patients
University of Louisville Physicians CurrentSince Jun 16, 2022 Accepting new patients
X-Ray Associates of Louisville PSC Diagnostic Radiology CurrentSince Mar 1, 2024 Accepting new patients
KND Development 59 LLC CurrentSince Jan 2, 2017 Accepting new patients
University of Louisville Physicians, Inc. Diagnostic Radiology CurrentSince Jun 16, 2022 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
KND Development 59, LLC CurrentSince Jan 2, 2017 Accepting new patients
Open MRI, LLC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1214 Spring St
Ste 2
Jeffersonvlle, IN 47130
Phone (812) 206-8002

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

2400 Eastpoint Pkwy
Ste 100
Louisville, KY 40223
Phone (502) 210-4700

530 S Jackson St
Ste C7
Louisville, KY 40202
Phone (502) 562-3000

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

1313 Saint Anthony Pl
Louisville, KY 40204
Phone (502) 587-7001

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 8

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1396708244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST STE C07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "OTIS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35-126232",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "44977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134089",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "820183",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201136370",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100135110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.