Individual provider Active NPI

Eugene Giles Sr., M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1558355438
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22657 Issued in KY
Practice address
1720 W Broadway Ste 107
Louisville, KY 40203-3607
Phone
(502) 340-5900
Fax
(502) 772-1761
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22657 KY
Internal Medicine Physician 207R00000X 22657 KY Primary

Addresses

Primary practice location

1720 W Broadway Ste 107
Louisville, KY 40203-3607

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5063

Other identifiers 4

IdentifierTypeStateIssuer
1049423OtherPASSPORT
64226574MedicaidKY
0400136OtherUNITED HEALTHCARE
000000062872OtherANTHEM

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address egiles43490@direct.nortonhealthcare.org
Direct Messaging Address egiles43490@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
I20050831000273 KY Practitioner - Internal Medicine 1355396193 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2020 Accepting new patients

Locations

2746 Virginia Ave
Louisville, KY 40211
Phone (502) 772-1883

1720 W Broadway
Ste 107
Louisville, KY 40203
Phone (502) 340-5900

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Organizations & group practices 3

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1558355438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5063",
            "fax_number": "502-772-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W BROADWAY STE 107",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033607",
            "telephone_number": "502-340-5900",
            "fax_number": "502-772-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILES",
        "first_name": "EUGENE",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22657",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "22657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1049423",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64226574",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0400136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000062872",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egiles43490@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "1720 W Broadway Ste 107",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402033607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egiles43490@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "1720 W Broadway Ste 107",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402033607",
            "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": "1720 W Broadway Ste 107",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402033607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.