Individual provider Active NPI

Stanley Lawrence Block Jr., MD

  • Pediatrics Physician
  • Bardstown, KY
National Provider Identifier
1619974821
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22184 Issued in KY
Practice address
201 S 5TH St
Bardstown, KY 40004-1142
Phone
(502) 348-6309
Fax
(502) 348-2793
NPI assigned
Jul 1, 2005
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 22184 KY Primary

Addresses

Primary practice location

201 S 5TH St
Bardstown, KY 40004-1142

Mailing address

201 S 5TH St
Bardstown, KY 40004-1142
Phone (502) 348-6309

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
I20091219000005 KY Practitioner - Pediatric Medicine 4183764376 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bardstown Primary Care, PLLC Pediatrics CurrentSince Apr 21, 2002 Accepting new patients
Bardstown Primary Care, PLLC CurrentSince Apr 21, 2002 Accepting new patients

Locations

201 S 5th St
Bardstown, KY 40004
Phone (502) 348-5968

805 Bardstown Rd
Springfield, KY 40069
Phone (606) 336-3952

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1619974821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 5TH ST",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041142",
            "telephone_number": "502-348-6309",
            "fax_number": "502-348-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 5TH ST",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041142",
            "telephone_number": "502-348-6309",
            "fax_number": "502-348-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "STANLEY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "22184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

Verify at the official NPI Registry.