New Source Medical, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

NEW SOURCE MEDICAL, LLC

Practice address

9913 Shelbyville Rd Ste 203
Louisville, KY 40223-2907

Phone

(502) 261-0050

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

Kevin A McKim

Title

Ceo

Phone

(502) 261-0050

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

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.

• Jessica Jackson, DPM

  • Podiatrist
  • New Albany, IN
  • NPI 1912947631

  KY

  Medicare reassignment

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1700425816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9913 SHELBYVILLE RD STE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232907",
            "telephone_number": "502-261-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9913 SHELBYVILLE RD STE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232907",
            "telephone_number": "502-261-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SOURCE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "MCKIM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-261-0050"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.newsourcenet.com",
            "affiliation": "N",
            "address_1": "9913 Shelbyville Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402232907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Podiatrist in Louisville, KY
• Providers in Louisville, KY by specialty
• Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.