NPIMap

Individual provider Active NPI

Kelly Z Brown, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Jeffersonville, IN
National Provider Identifier
1568569234
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01049440 Issued in IN
Practice address
1220 Missouri Ave
Pathology Dept
Jeffersonville, IN 47130-3725
Phone
(812) 283-2169
Fax
(502) 456-4440
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01049440 IN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 30049 KY

Addresses

Primary practice location

1220 Missouri Ave
Pathology Dept
Jeffersonville, IN 47130-3725

Mailing address

1941 Bishop LN Ste 1018
Louisville, KY 40218-1928
Phone (502) 456-6211

Other identifiers 7

IdentifierTypeStateIssuer
50015821OtherKYPASSPORT
2873452000OtherKYPASSPORT ADVANTAGE
P00709200OtherKYMEDICARE RR
000000526547OtherINANTHEM
200206660AMedicaidIN
64017668MedicaidKY
P00430449OtherINMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070731000385 IN Practitioner - Pathology 6608977970 Reassigns benefits to 1 organization
I20070801000735 KY Practitioner - Pathology 6608977970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Indiana University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Pathology Consultants, LLCGroup PAC ID 8527169895, 3 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (812) 283-2169

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone (502) 456-6217

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01049440INMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Consultants LLC Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2007 Accepting new patients
East Louisville Pathologists PSC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Associated Pathologists LLC Past Accepting new patients
Pathgroup Labs, LLC Past Accepting new patients

Locations

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

1941 Bishop Ln
Ste 1018
Louisville, KY 40218

1169 Eastern Pkwy
Ste G71
Louisville, KY 40217
Phone (502) 456-6211

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1568569234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 1018",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181928",
            "telephone_number": "502-456-6211",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MISSOURI AVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303725",
            "telephone_number": "812-283-2169",
            "fax_number": "502-456-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KELLY",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01049440",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "30049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50015821",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2873452000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00709200",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000526547",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200206660A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64017668",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00430449",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.