Individual provider Active NPI

Robert L. Berlin, M.D.

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1790740611
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31271 Issued in KY
Practice address
7092 Distribution Dr
Suite E
Louisville, KY 40258-2877
Phone
(502) 935-9970
Fax
(502) 935-9577
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

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 Medicine

State licenses

LicenseStateTypeSpecialty
31271KYMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckiana Emergency Physicians Past Accepting new patients
CG Medical Associates Inc PastSince Dec 1, 2021 Accepting new patients
Louisville Emergency Medicine Associates PSC Emergency Medicine Past Accepting new patients
Kentuckiana Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 31271 KY
Emergency Medicine Physician 207P00000X 31271 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

7092 Distribution Dr
Suite E
Louisville, KY 40258-2877

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (502) 489-5730

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
64312713MedicaidKY

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address rberlin5998@bhkydirect.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 8, 2020.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1790740611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7092 DISTRIBUTION DR",
            "address_2": "SUITE E",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402582877",
            "telephone_number": "502-935-9970",
            "fax_number": "502-935-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": "31271",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "31271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64312713",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rberlin5998@bhkydirect.com",
            "affiliation": "N",
            "address_1": "7092 Distribution Dr",
            "address_2": "Suite E",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402582877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 8, 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.