Individual provider Active NPI

Jeffery B. Gilbertson, M. DIV

  • Specialist
  • Louisville, KY
National Provider Identifier
1831309723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
KY-06-035 Issued in KY
Practice address
1203 Watterson TRL
Louisville, KY 40299-2329
Phone
(502) 253-8425
Fax
(502) 253-8433
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X KY-06-035 KY Primary

Addresses

Primary practice location

1203 Watterson TRL
Louisville, KY 40299-2329

Mailing address

7602 Park Place Cir
Crestwood, KY 40014-7540
Phone (502) 241-3129

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
KY-06-035KYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831309723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 PARK PLACE CIR",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400147540",
            "telephone_number": "502-241-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 WATTERSON TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992329",
            "telephone_number": "502-253-8425",
            "fax_number": "502-253-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "JEFFERY",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "M. DIV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "KY-06-035",
            "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 8, 2007; 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.