NPIMap

Organization Active NPI

Upa Neurosurgery

  • Neurological Surgery Physician
  • Louisville, KY
National Provider Identifier
1669758975
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
UPA NEUROSURGERY
Practice address
550 S Jackson St
1St Floor
Louisville, KY 40202-1622
Phone
(502) 562-6501
Fax
(502) 562-6502
NPI assigned
Nov 1, 2011
Last updated
Nov 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
Thomas Kelly
Title
VP of Operations
Phone
(502) 217-5120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

550 S Jackson St
1St Floor
Louisville, KY 40202-1622

Mailing address

501 E Broadway
Ste 290
Louisville, KY 40202-1785
Phone (502) 217-5134

Other identifiers 1

IdentifierTypeStateIssuer
31000102MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Continence Ctr Univ of Louisville3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1669758975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY",
            "address_2": "STE 290",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021785",
            "telephone_number": "502-217-5134",
            "fax_number": "502-217-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST",
            "address_2": "1ST FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-562-6501",
            "fax_number": "502-562-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPA NEUROSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "502-217-5120"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31000102",
            "state": "KY"
        }
    ],
    "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 Nov 1, 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.