NPIMap

Organization Active NPI

University Surgical Associates, PSC

  • Surgery Physician
  • Louisville, KY
National Provider Identifier
1609847367
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
UNIVERSITY SURGICAL ASSOCIATES, PSC
Practice address
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone
(502) 583-8303
Fax
(502) 584-0302
NPI assigned
Jan 31, 2006
Last updated
Dec 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Mr. Timothy D. Crockett, CEO
Title
Ceo
Phone
(502) 583-8303

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X
Colon & Rectal Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208C00000X
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700

Mailing address

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303

National Provider Directory

National Provider Directory
Tax ID family
University Surgical Associates PSC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105B Greenbriar Dr
Campbellsville, KY 42718
Phone (270) 465-0632

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1609847367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SURGICAL ASSOCIATES, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-583-8303",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 21, 2011; 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.