Jamie D Mudd, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

57756 Issued in KY

Practice address

20 Medical Village Dr.
Suite 102
Edgewood, KY 41017-5402

Phone

(859) 341-1011

Fax

(859) 341-7198

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jamie.muddmd.p6@direct.cps.nextgenshare.com
• Direct secure messaging: jamie.muddmd.p6@direct.kypeds.nextgenshare.com

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.

• Pediatric Care of Kentucky PSC

  • Pediatrics Physician
  • Edgewood, KY
  • NPI 1598739849
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1639672579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR.",
            "address_2": "SUITE 102",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175402",
            "telephone_number": "859-341-1011",
            "fax_number": "859-341-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR.",
            "address_2": "SUITE 102",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175402",
            "telephone_number": "859-341-1011",
            "fax_number": "859-341-7198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDD",
        "first_name": "JAMIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "57756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepthi R Mosali, MD
• David Mosko Jr., MD
• Mallory Naber Mosko, PA-C
• Nancy Moss, CNM
• Cathleen M Mucenski, M.D.
• Sanjoydeb Mukherjee, MD
• Thresiamma A Mukkada, MD
• Rose Lynn Mulberry, APRN
• Katelyn Rose Mullen, BCBA
• Anastasia Muncy

• Pediatrics Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.