Active NPI
Ankur Datta, M.D.
- Neonatal-Perinatal Medicine Physician
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 58279
- Practice address
- 4123 Dutchmans LN Ste 606
Louisville, KY 40207-4725 - Phone
- (502) 896-2500
- NPI assigned
- Mar 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 036.128019 | IL | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 58279 | KY | Primary |
Addresses
Primary practice location
4123 Dutchmans LN Ste 606
Louisville, KY 40207-4725
Mailing address
PO Box 776879
Chicago, IL 60677-2991
Phone (502) 588-9490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.128019 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.128019 | IL | MD | Neonatal-Perinatal Medicine Physician |
| 58279 | KY | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children'S Medical Group Inc | Current | Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Norton Children'S Medical Group, LLC | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Norton Childrens Medical Group, LLC | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Norton Hospitals, Inc | Past | Accepting new patients |
Locations
Claims Remittance
Carol Stream, IL 60122
225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415
737 N Michigan Ave
Ste 2040
Chicago, IL 60611
2051 Clevidence Blvd
Ste C
Clarksville, IN 47129
Phone (812) 280-6623
2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030
1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072
411 E Chestnut St
#2
Louisville, KY 40202
Phone (502) 588-0902
601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670
4123 Dutchmans Ln
Ste 606
Louisville, KY 40207
Phone (502) 896-2500
200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000
1000 Breckenridge St
Ste 301
Owensboro, KY 42303
Phone (270) 852-8894
Interoperability endpoints
- adatta276558@direct.nortonhealthcare.org
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 and National Provider Directory roles.
-
- Psychiatry Physician
- Louisville, KY
- NPI 1457999096
-
- Pediatrics Physician
- Louisville, KY
- NPI 1326695255
IN, Neonatal-Perinatal Medicine
-
- Pediatrics Physician
- Chicago, IL
- NPI 1518064716
-
- Neonatal-Perinatal Medicine Physician
- Louisville, KY
- NPI 1144862301
-
- Pediatric Radiology Physician
- Louisville, KY
- NPI 1659913812
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1891799227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1750553665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776879",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606772991",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4123 DUTCHMANS LN STE 606",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074725",
"telephone_number": "502-896-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATTA",
"first_name": "ANKUR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-31",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "036.128019",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "KY",
"license": "58279",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036.128019",
"state": "IL"
}
],
"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 Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.