Active NPI
Diller Baer Groff, M.D.
- Pediatric Surgery Physician
- Louisville, KY
National Provider Identifier
1699114462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 19457
- Practice address
- 5405 Indian Woods Dr
Louisville, KY 40207-2066 - Phone
- (502) 895-0842
- NPI assigned
- Jun 14, 2013
- Last updated
- Jun 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 19457 | KY | Primary |
Addresses
Primary practice location
5405 Indian Woods Dr
Louisville, KY 40207-2066
Mailing address
5405 Indian Woods Dr
Louisville, KY 40207-2066
Phone (502) 895-0842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19457 | KY | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371168000000",
"number": "1699114462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5405 INDIAN WOODS DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402072066",
"telephone_number": "502-895-0842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 INDIAN WOODS DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402072066",
"telephone_number": "502-895-0842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROFF",
"first_name": "DILLER",
"middle_name": "BAER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-14",
"last_updated": "2013-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "KY",
"license": "19457",
"primary": true
}
],
"identifiers": [],
"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 Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.