Individual provider Active NPI

Paul E Brown, MD

  • Gastroenterology Physician
  • Louisville, KY
National Provider Identifier
1659355774
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
24669 Issued in KY
Practice address
1169 Eastern Pkwy
G58
Louisville, KY 40217
Phone
(502) 452-9567
Fax
(502) 473-0586
NPI assigned
Dec 1, 2005
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 24669 KY Primary

Addresses

Primary practice location

1169 Eastern Pkwy
G58
Louisville, KY 40217

Mailing address

2020 Exeter Rd
Germantown, TN 38138-3945

Other identifiers 2

IdentifierTypeStateIssuer
1049202OtherKYPASSPORT
64246697MedicaidKY

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
I20040219000498 KY Practitioner - Gastroenterology 1355236191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24669KYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Endoscopy Center, PLLC Current Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2022 Accepting new patients

Locations

3 Audubon Plaza Dr
Ste 530
Louisville, KY 40217
Phone (502) 629-3820

3999 Dutchmans Ln
Ste 7B
Louisville, KY 40207
Phone (502) 272-5552

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Organizations & group practices 6

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1659355774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 EXETER RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "G58",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40217",
            "telephone_number": "502-452-9567",
            "fax_number": "502-473-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "24669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1049202",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64246697",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.