Michael John Light, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

36355 Issued in KY

Practice address

1108 Main Street
Shelbyville, KY 40065

Phone

(502) 513-5058

Fax

(502) 513-5215

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Psychiatry

Education

University of Louisville School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PPL Therapeutic Services PLLCGroup PAC ID 8527323989, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• PPL Therapeutic Services PLLC

  • Professional Counselor
  • Crestwood, KY
  • NPI 1104323252

  Psychiatry

  Medicare reassignment Care Compare group NPD
• River Region Psychiatry Associates LLC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  KY

  Medicare reassignment NPD
• Ambassador Counseling Services

  • Counselor
  • Louisville, KY
  • NPI 1881892040
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Hodgenville, KY
  • NPI 1821419789
  NPD (past)
• St. Luke Hospitals Inc

  • Obstetrics & Gynecology Physician
  • Fort Thomas, KY
  • NPI 1902910987
  NPD (past)
• Park View Psychiatric Services, PSC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1487872636
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1508863648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 MAIN STREET",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-513-5058",
            "fax_number": "502-513-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 MAIN STREET",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-513-5058",
            "fax_number": "502-513-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01056762A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "36355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64038847",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003610101A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelin Marie Lester
• Molly A Lester, MS, OTR/L
• Kayley Letcher, OT
• Alison Hill Lewis
• Shannon Faye Lewis, LPN
• Cameron Lee Lile
• Kellie Marie Lisby, APRN
• Emily Logsdon, LPCC-S
• Kaylee Dawn Logue
• Raymond H. Lohr, D.M.D.

• Psychiatry Physician in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.