Louisville Surgical Associates, PSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

LOUISVILLE SURGICAL ASSOCIATES, PSC

Practice address

4402 Churchman Ave
Suite 202
Louisville, KY 40215-1190

Phone

(502) 366-1090

Fax

(502) 366-1564

NPI assigned

Aug 18, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Terri L Willett

Title

Office Manager

Phone

(502) 366-1090

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John N Olsofka, M.D.

  • Surgery Physician
  • Louisville, KY
  • NPI 1013919273
  NPD
• Rodney D McMillin, M.D.

  • Surgery Physician
  • Louisville, KY
  • NPI 1467454637
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1770575516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE",
            "address_2": "SUITE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151190",
            "telephone_number": "502-366-1090",
            "fax_number": "502-366-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE",
            "address_2": "SUITE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151190",
            "telephone_number": "502-366-1090",
            "fax_number": "502-366-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE SURGICAL ASSOCIATES, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "WILLETT",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-366-1090",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000060149",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65920985",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN1016",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1049011",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.