Individual provider Active NPI

John Nicholas Kravic, PH.D.

  • Psychologist
  • Louisville, KY
National Provider Identifier
1770660888
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0721 Issued in KY
Practice address
111 S Sherrin Ave
Louisville, KY 40207-3221
Phone
(502) 895-9999
Fax
(502) 895-9999
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0721 KY
Counseling Psychologist 103TC1900X 0721 KY
Clinical Child & Adolescent Psychologist 103TC2200X 0721 KY
Family Psychologist 103TF0000X 0721 KY
Psychologist 103T00000X 0721 KY Primary
Marriage & Family Therapist 106H00000X 0035 KY

Addresses

Primary practice location

111 S Sherrin Ave
Louisville, KY 40207-3221

Mailing address

111 S Sherrin Ave
Louisville, KY 40207-3221
Phone (502) 895-9999

Other identifiers 7

IdentifierTypeStateIssuer
17608 V14833OtherKYALTERNATIVE HEALTH
7585141OtherKYAETNA
000000041691OtherKYBLUE CROSS BLUE SHIELD
KY0003291OtherKYTRICARE
044837OtherKYVALUE OPTIONS
62-52930OtherKYUNITED BEHAVIORAL
75671OtherKYCMG

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0035KYMDPastoral Counselor
0721KYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1770660888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S SHERRIN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073221",
            "telephone_number": "502-895-9999",
            "fax_number": "502-895-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S SHERRIN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073221",
            "telephone_number": "502-895-9999",
            "fax_number": "502-895-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVIC",
        "first_name": "JOHN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "0721",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KY",
            "license": "0721",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KY",
            "license": "0721",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "KY",
            "license": "0721",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "0721",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "0035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTERNATIVE HEALTH",
            "identifier": "17608 V14833",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7585141",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000041691",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "KY0003291",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "044837",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL",
            "identifier": "62-52930",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMG",
            "identifier": "75671",
            "state": "KY"
        }
    ],
    "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 11, 2025; 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.