Individual provider Active NPI

Emily Joy Tan, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1518069681
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39857 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-4750
Fax
(502) 629-4617
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39857 KY Primary

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Other identifiers 2

IdentifierTypeStateIssuer
200883390MedicaidIN
7100018860MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address etan43553@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

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
I20070802000357 KY Practitioner - Pediatric Medicine 3971694118 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics Current Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
University of Louisville Phyisicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
Norton Hospitals, Inc Past Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

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

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

411 E Chestnut St
#4B
Louisville, KY 40202
Phone (502) 588-3600

1100 E Market St
Louisville, KY 40206
Phone (502) 596-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1518069681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-4750",
            "fax_number": "502-629-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "EMILY",
        "middle_name": "JOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200883390",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100018860",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "etan43553@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.