Individual provider Active NPI

Kaitlin Gordon

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1558723908
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52271 Issued in KY
Practice address
401 E Chestnut St Unit 310
Louisville, KY 40202
Phone
(502) 589-6788
Fax
(502) 589-5093
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52271 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X 52271 KY

Addresses

Primary practice location

401 E Chestnut St Unit 310
Louisville, KY 40202

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (025) 626-5105

Other practice location 1

550 S Jackson St
Louisville, KY 40202-1622
Phone (502) 852-5666

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
I20190530000145 KY Practitioner - Internal Medicine 7810268729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Louisville Physicians IncGroup PAC ID 3476725599, 1,438 clinicians

Practice addresses (Care Compare)

401 E Chestnut St
Suite 310
Louisville, KY 40202-5703
Phone (502) 584-8563

Hospital & facility affiliations

  • University of Louisville Hospital Hospital, Louisville, KY, CCN 180141

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52271KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jun 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
University Medical Center, Inc Student in an Organized Health Care Education/Training Program Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

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

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1558723908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "025-626-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-589-6788",
            "fax_number": "502-589-5093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021622",
            "country_code": "US",
            "telephone_number": "502-852-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "52271",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "52271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.