Active NPI
Susan C Coventry, MD
- Anatomic Pathology Physician
- Louisville, KY
National Provider Identifier
1881629558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 34658
- Practice address
- 231 E Chestnut St
Pathology Dept
Louisville, KY 40202-1821 - Phone
- (502) 629-7900
- Fax
- (502) 629-7906
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pathology Physician | 207ZP0213X | 34658 | KY | |
| Anatomic Pathology Physician | 207ZP0101X | 34658 | KY | Primary |
Addresses
Primary practice location
231 E Chestnut St
Pathology Dept
Louisville, KY 40202-1821
Mailing address
1941 Bishop LN Ste 1018
Louisville, KY 40218-1928
Phone (502) 456-6211
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000049668 | Other | KY | ANTHEM BLUE CROSS BS |
| P00211997 | Other | RAILROAD MEDICARE | |
| 1087837 | Other | KY | PASSPORT MEDICAID |
| 1337243 | Other | UNITED MINE WORKERS | |
| 200206670A | Medicaid | IN | |
| 64346588 | Medicaid | KY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1881629558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1941 BISHOP LN STE 1018",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402181928",
"telephone_number": "502-456-6211",
"fax_number": "502-456-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 E CHESTNUT ST",
"address_2": "PATHOLOGY DEPT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021821",
"telephone_number": "502-629-7900",
"fax_number": "502-629-7906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COVENTRY",
"first_name": "SUSAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0213X",
"taxonomy_group": "",
"desc": "Pathology, Pediatric Pathology",
"state": "KY",
"license": "34658",
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "KY",
"license": "34658",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BS",
"identifier": "000000049668",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00211997",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT MEDICAID",
"identifier": "1087837",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINE WORKERS",
"identifier": "1337243",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200206670A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64346588",
"state": "KY"
}
],
"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 Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.