Individual provider Active NPI

Katherine E Caldwell, M.D.

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1790076487
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47092 Issued in KY
Practice address
4123 Dutchmans LN
Suite 301
Louisville, KY 40207-4707
Phone
(502) 899-6981
Fax
(502) 896-2527
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 47092 KY Primary

Addresses

Primary practice location

4123 Dutchmans LN
Suite 301
Louisville, KY 40207-4707

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
2150031MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031000751 CA Practitioner - Pediatric Medicine 2567688773 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47092KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Nov 1, 2016 Accepting new patients
University of California San Francisco CurrentSince Nov 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 1, 2016 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Nov 1, 2016 Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1790076487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN",
            "address_2": "SUITE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074707",
            "telephone_number": "502-899-6981",
            "fax_number": "502-896-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "47092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2150031",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.