Individual provider Active NPI

Gina C Wilkins, MD

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1407968019
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33258 Issued in KY
Practice address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone
(502) 636-7111
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33258 KY
Emergency Medicine Physician 207P00000X 33258 KY Primary

Addresses

Primary practice location

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Mailing address

1155 W 3Rd St
Bloomington, IN 47404-5016
Phone (812) 336-1690

Other identifiers 3

IdentifierTypeStateIssuer
33258OtherKYKY LICENSE
64332588MedicaidKY
000000710412OtherKYANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050607001105 KY Practitioner - Emergency Medicine 1456394717 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33258KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 16, 2005 Accepting new patients
Louisville Radiology Imaging Consultants, PLLC Past Accepting new patients
Ky-I Medical Services, P.S.C. Past Accepting new patients
Urgent Care Services Southeast PSC PastSince Oct 1, 2023 Accepting new patients
Kentuckiana Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Kentuckiana Emergency Physicians Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

299 Kings Daughters Dr
Hatton, KY 40601
Phone (502) 875-5240

320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407968019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 W 3RD ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474045016",
            "telephone_number": "812-336-1690",
            "fax_number": "812-349-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-636-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "GINA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33258",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "33258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "33258",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64332588",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000710412",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.