Individual provider Active NPI

Jeffrey M. Bumpous, MD

  • Otolaryngology Physician
  • Louisville, KY
National Provider Identifier
1508846528
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
30850 Issued in KY
Practice address
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone
(502) 583-8303
Fax
(502) 584-0302
NPI assigned
Jan 17, 2006
Last updated
Jul 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 30850 KY Primary

Addresses

Primary practice location

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700

Mailing address

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303

Other identifiers 3

IdentifierTypeStateIssuer
100374010AMedicaidIN
1051214OtherKYPASSPORT
64308505MedicaidKY

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
I20070905000422 KY Practitioner - Otolaryngology 8123926284 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians Inc. CurrentSince Mar 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 710
Louisville, KY 40202
Phone 50258383031332

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

550 S Jackson St
Fl First
Louisville, KY 40202
Phone (502) 852-0011

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Louisville HospitalLouisville, KY, CCN 180141 Hospital Corporate Director Nov 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1508846528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMPOUS",
        "first_name": "JEFFREY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "30850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100374010A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1051214",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64308505",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.