NPIMap

Individual provider Active NPI

Charles Smith, MD

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1881615235
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20296 Issued in KY
Practice address
12010 Shelbyville Rd
Suite 500
Louisville, KY 40243-1054
Phone
(502) 238-2800
Fax
(502) 238-2805
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20296 KY Primary

Addresses

Primary practice location

12010 Shelbyville Rd
Suite 500
Louisville, KY 40243-1054

Mailing address

13117 Eastpoint Park Blvd
Suite D
Louisville, KY 40223-4193
Phone (502) 238-2801

Other identifiers 3

IdentifierTypeStateIssuer
000000182121OtherBCBS
64202963MedicaidKY
P00239216OtherRR MCR

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
20296KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group, Inc. Emergency Medicine Past Accepting new patients
Louisville Emergency Medicine Associates PSC Emergency Medicine Past Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients
Baptist Medical Associates, Inc. Past Accepting new patients
Marshall Emergency Services Associates, PLLC Emergency Medicine Past Accepting new patients
Norton - Kings Daughters Health Inc Past Accepting new patients
Kentucky Em-I Medical Services PSC Past Accepting new patients
Green River Emergency Physicians Emergency Medicine Past Accepting new patients
4MD2 Physician Services of Bowling Green LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 9

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1881615235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13117 EASTPOINT PARK BLVD",
            "address_2": "SUITE D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234193",
            "telephone_number": "502-238-2801",
            "fax_number": "502-238-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 SHELBYVILLE RD",
            "address_2": "SUITE 500",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431054",
            "telephone_number": "502-238-2800",
            "fax_number": "502-238-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "20296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000182121",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64202963",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00239216",
            "state": null
        }
    ],
    "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 Jan 18, 2008; 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.