NPIMap

Individual provider Active NPI

George Spencer

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1740254382
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01052919A Issued in IN
Practice address
4000 Kresge Way
Louisville, KY 40207-4605
Phone
(502) 897-8281
NPI assigned
Feb 13, 2006
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01052919A IN Primary
Diagnostic Radiology Physician 2085R0202X 49391 KY

Addresses

Primary practice location

4000 Kresge Way
Louisville, KY 40207-4605

Mailing address

702 Executive Park
Louisville, KY 40207-4207
Phone (502) 895-5405

Other identifiers 1

IdentifierTypeStateIssuer
7100410870MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110223000585 IN Practitioner - Diagnostic Radiology 9931286135 Reassigns benefits to 2 organizations
I20160712003086 KY Practitioner - Diagnostic Radiology 9931286135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Ray Associates of Louisville PSCGroup PAC ID 9436146818, 55 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8121

7600 S Seven Gables St
Terre Haute, IN 47802-9655
Phone (502) 895-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49391KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital, Inc. Diagnostic Radiology Current Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Jul 15, 2019 Accepting new patients
X-Ray Associates of Louisville PSC Diagnostic Radiology CurrentSince Aug 11, 2016 Accepting new patients
Radiology Associates Inc Diagnostic Radiology Past Accepting new patients

Locations

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

221 S 6th St
Terre Haute, IN 47807
Phone (812) 242-3157

702 Executive Park
Louisville, KY 40207

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 4

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1740254382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074207",
            "telephone_number": "502-895-5405",
            "fax_number": "502-894-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01052919A",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "49391",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100410870",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.