Community Health Group LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

COMMUNITY HEALTH GROUP LLC

Practice address

2932 Breckenridge LN Ste 5
Louisville, KY 40220-1490

Phone

(502) 371-9703

Fax

(502) 540-3070

NPI assigned

Apr 29, 2024

Last updated

Apr 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohammad Ali Haider, DONPI 1871622258

Title

Owner

Phone

(502) 640-0124

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 2

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.

• Mary Robin Larkin, MD

  • Psychiatry Physician
  • Meridian, MS
  • NPI 1013056555

  KY

  Medicare reassignment NPD
• Mohammad Ali Haider, D.O.

  • Ophthalmology Physician
  • Louisville, KY
  • NPI 1871622258
  NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1639925753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2932 BRECKENRIDGE LN STE 5",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201490",
            "telephone_number": "502-371-9703",
            "fax_number": "502-540-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2932 BRECKENRIDGE LN STE 5",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201490",
            "telephone_number": "502-371-9703",
            "fax_number": "502-540-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "HAIDER",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-640-0124",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.