Kenneth Lee Mudd, MD, MSC, BS

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

IP0977 Issued in KY

Practice address

1081 Eastern Pkwy
Louisville, KY 40217-1559

Phone

(502) 996-0787

Fax

(502) 890-2857

NPI assigned

Feb 3, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1487285029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 EASTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171559",
            "telephone_number": "502-996-0787",
            "fax_number": "502-890-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 EASTERN PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171559",
            "telephone_number": "502-996-0787",
            "fax_number": "502-890-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "credential": "MD, MSC, BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "IP0977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Mudd, M.ED.
• Debra Kay Mudd, NP
• Glennesha Mudd, CSW
• John Paul Mudd, PMHNP-BC
• Kara Travis Mudd, PA-C
• Kristin Nicole Mudd, DPT
• Leslie B Mudd, PHARMD
• Mary Ann Mudd, M.S. CCC-SLP
• Regina Mudd
• Samantha Lee Mudd, DMD

• Obstetrics & Gynecology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Obstetrics & Gynecology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.