Organization Active NPI

Brownsboro Dermatology PLLC

  • Dermatology Physician
  • Louisville, KY
National Provider Identifier
1508911256
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
26744 Issued in KY
Legal business name
BROWNSBORO DERMATOLOGY PLLC
Practice address
4938 Brownsboro Rd
Suite 206
Louisville, KY 40222-6374
Phone
(502) 339-2922
Fax
(502) 339-2912
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Mrs. Karen J Mosgrove
Title
Office Manager
Phone
(502) 339-2922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 26744 KY Primary

Addresses

Primary practice location

4938 Brownsboro Rd
Suite 206
Louisville, KY 40222-6374

Mailing address

4938 Brownsboro Rd
Suite 206
Louisville, KY 40222-6374
Phone (502) 339-2922

National Provider Directory

National Provider Directory

Locations

4938 Brownsboro Rd
Ste 206
Louisville, KY 40222
Phone (502) 339-2922

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1508911256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4938 BROWNSBORO RD",
            "address_2": "SUITE 206",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226374",
            "telephone_number": "502-339-2922",
            "fax_number": "502-339-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4938 BROWNSBORO RD",
            "address_2": "SUITE 206",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226374",
            "telephone_number": "502-339-2922",
            "fax_number": "502-339-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWNSBORO DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "MOSGROVE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-339-2922",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": "26744",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 16, 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.