NPIMap

Individual provider Active NPI

Kunnathu P. Geevarghese, MD

  • Pain Medicine (Anesthesiology) Physician
  • Louisville, KY
National Provider Identifier
1417040742
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
16440 Issued in KY
Practice address
4402 Churchman Ave
Suite 302
Louisville, KY 40215-1190
Phone
(502) 366-7317
Fax
(502) 366-7318
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16440 KY
Pain Medicine (Anesthesiology) Physician 207LP2900X 16440 KY Primary

Addresses

Primary practice location

4402 Churchman Ave
Suite 302
Louisville, KY 40215-1190

Mailing address

4402 Churchman Ave
Suite 302
Louisville, KY 40215-1190
Phone (502) 366-7317

Other identifiers 13

IdentifierTypeStateIssuer
1131109OtherPASSPORT
050078005OtherMEDICARE RAILROAD
C3647401OtherHUMANA
000000187640OtherKY STATE DISTRICT CO
000000187640OtherONE NATION BENEFIT
40090988000OtherCOMP MANAGEMENT
64164403MedicaidKY
2437681000OtherPASSPORT ADVANTAGE
000000187640OtherANTHEM BCBS
0004012479OtherAETNA
000000187460OtherUNICARE
000000187640OtherKY ACCESS
64164403OtherKENPAC

Medicare participation

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Hospitals, Inc Past Accepting new patients
PCN Surgical Suites, LLC Past Accepting new patients
Anesthesia Associates of Louisville, PSC Anesthesiology Past Accepting new patients
Pain Control Network, PSC Past Accepting new patients

Organizations & group practices 4

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1417040742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE",
            "address_2": "SUITE 302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151190",
            "telephone_number": "502-366-7317",
            "fax_number": "502-366-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE",
            "address_2": "SUITE 302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151190",
            "telephone_number": "502-366-7317",
            "fax_number": "502-366-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEEVARGHESE",
        "first_name": "KUNNATHU",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "16440",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "16440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1131109",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050078005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "C3647401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY STATE DISTRICT CO",
            "identifier": "000000187640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE NATION BENEFIT",
            "identifier": "000000187640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP MANAGEMENT",
            "identifier": "40090988000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64164403",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2437681000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000187640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004012479",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "000000187460",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY ACCESS",
            "identifier": "000000187640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENPAC",
            "identifier": "64164403",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.