NPIMap

Organization Active NPI

St Matthews Neurology PSC

  • Neurology Physician
  • New Albany, IN
National Provider Identifier
1447475983
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
26502 Issued in KY
Legal business name
ST MATTHEWS NEUROLOGY PSC
Practice address
1850 State St
New Albany, IN 47150-4990
Phone
(502) 899-1193
Fax
(502) 897-7233
NPI assigned
Apr 17, 2007
Last updated
Jan 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Dr. John Melton, MDNPI 1235206723
Title
President
Phone
(502) 899-1193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 26502 KY Primary

Addresses

Primary practice location

1850 State St
New Albany, IN 47150-4990

Mailing address

134 Travois Rd
Louisville, KY 40207-1673
Phone (502) 899-1193

Other identifiers 3

IdentifierTypeStateIssuer
1157158OtherKYPASSPORT
65936692MedicaidKY
000000187098OtherKYANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1447475983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 TRAVOIS RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071673",
            "telephone_number": "502-899-1193",
            "fax_number": "502-897-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 STATE ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504990",
            "telephone_number": "502-899-1193",
            "fax_number": "502-897-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MATTHEWS NEUROLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-899-1193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "26502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1157158",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65936692",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000187098",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.