J P McCubbin MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

J P MCCUBBIN MD PLLC

Practice address

4519 Wolfcreek Pkwy
Louisville, KY 40241-5501

Phone

(502) 742-9164

Fax

(502) 742-9395

NPI assigned

Jun 8, 2009

Organization subpart

No

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

Authorized official

Name

Jason P McCubbin, M.D.

Title

President

Phone

(502) 742-9164

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1770719577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 WOLFCREEK PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402415501",
            "telephone_number": "502-742-9164",
            "fax_number": "502-742-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 WOLFCREEK PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402415501",
            "telephone_number": "502-742-9164",
            "fax_number": "502-742-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J P MCCUBBIN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "MCCUBBIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-742-9164",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100072840",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.