Gary Goldblatt, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24422 Issued in KY

Practice address

105 Lyndon LN
Suite B
Louisville, KY 40222-5550

Phone

(502) 896-0707

NPI assigned

Jan 13, 2007

Last updated

Jun 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1932250362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5338",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402550338",
            "telephone_number": "502-896-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LYNDON LN",
            "address_2": "SUITE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225550",
            "telephone_number": "502-896-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "24422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6424422100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.