John T Mahan, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

28822 Issued in KY

Practice address

1741 Midland TRL
Shelbyville, KY 40065-1711

Phone

(502) 633-0192

Fax

(502) 633-0192

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bluegrass Osteoporosis Center, PLLC

  • Bone Densitometry Radiologic Technologist
  • Shelbyville, KY
  • NPI 1134132285
  NPD (past)
• Hughston Clinic, P.C.

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1164461190
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1780665174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 VILLAGE PLZ",
            "address_2": "PMB 136",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "40065",
            "telephone_number": "502-633-0192",
            "fax_number": "502-633-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 MIDLAND TRL",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651711",
            "telephone_number": "502-633-0192",
            "fax_number": "502-633-0192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 E Liberty St",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021530",
            "country_code": "US",
            "telephone_number": "502-585-2300",
            "fax_number": "502-584-2726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "KY",
            "license": "28822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT (JPG)",
            "identifier": "50040687",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200143910A/B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64288228",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Optometric Centers, III PSC
• Arlyn E. Lua-Canby, M.D.
• Kristen Murphy Luttrell, PT
• Stephenie A Lutz, PT, DPT
• Sara Lynch, SLP
• Caitin Mann
• Leslie Ann Mann, MS, OTR/L
• Faiyad Yaseer Mannan, MD
• Richard Manuel, RPH
• Maple Grove Senior Living LLC

• Orthopaedic Surgery of the Spine Physician in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Orthopaedic Surgery of the Spine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.