Active NPI
Nicholas Edwin Yates, MD
- Pediatrics Physician
- Louisville, KY
National Provider Identifier
1821670639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 62321
- Practice address
- 411 E Chestnut St
Louisville, KY 40202-1713 - Phone
- (502) 588-3220
- NPI assigned
- Apr 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 62321 | KY | |
| Pediatrics Physician | 208000000X | 62321 | KY | Primary |
Addresses
Primary practice location
411 E Chestnut St
Louisville, KY 40202-1713
Mailing address
PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490
Other practice location 1
500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696
Other practice location 2
3333 Burnet Ave # Mlc5018
Cincinnati, OH 45229-3026
Phone (513) 636-4315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1821670639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776879",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776879",
"telephone_number": "502-588-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 E CHESTNUT ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021713",
"telephone_number": "502-588-3220"
}
],
"practiceLocations": [
{
"address_1": "500 S Preston St Rm 305",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402021702",
"country_code": "US",
"telephone_number": "502-852-8696",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3333 Burnet Ave # Mlc5018",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452293026",
"country_code": "US",
"telephone_number": "513-636-4315",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YATES",
"first_name": "NICHOLAS",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-22",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "KY",
"license": "62321",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "62321",
"primary": true
}
],
"identifiers": [],
"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 Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.