Individual provider Active NPI

Kristin O. Donovan, M.D.

  • Dermatology Physician
  • Louisville, KY
National Provider Identifier
1952316770
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
29695 Issued in KY
Practice address
3810 Springhurst Blvd
Suite 200
Louisville, KY 40241
Phone
(502) 583-1749
Fax
(502) 329-8184
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 29695 KY Primary

Addresses

Primary practice location

3810 Springhurst Blvd
Suite 200
Louisville, KY 40241

Mailing address

PO Box 950132
Louisville, KY 40295-0132
Phone (888) 980-8992

Other identifiers 2

IdentifierTypeStateIssuer
64296957MedicaidKY
200087050MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001310 KY Practitioner - Dermatology 4486546629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Louisville School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Dermatology, PLLCGroup PAC ID 1658263876, 37 clinicians

Practice addresses (Care Compare)

1028 N Dixie Ave
Ste. 102
Elizabethtown, KY 42701-2508
Phone (502) 583-1749

3810 Springhurst Blvd
Louisville, KY 40241-6162
Phone (502) 583-1749

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions906
Removal or shaving of skin growth15
Skin biopsy192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Dermatology, PLLC Dermatology CurrentSince Mar 28, 1997 Accepting new patients

Locations

700 Portland Ave
Ste B
Bardstown, KY 40004
Phone (270) 234-6695

1028 N Dixie Ave
Ste 140
Elizabethtown, KY 42701

325 W Walnut St
Ste 300
Lebanon, KY 40033
Phone (270) 692-0735

506 S Main St
Leitchfield, KY 42754
Phone (270) 200-1095

3810 Springhurst Blvd
Ste 200
Louisville, KY 40241
Phone (317) 780-7400

1700 Old Bluegrass Ave
Ste 300
Louisville, KY 40215
Phone (502) 361-0288

4001 Kresge Way
Louisville, KY 40207
Phone (502) 897-2599

310 E Broadway
Ste 200
Louisville, KY 40202
Phone (502) 585-5249

3810 Springhurst Blvd
Louisville, KY 40241
Phone (502) 322-1954

Organizations & group practices 1

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1952316770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950132",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950132",
            "telephone_number": "888-980-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 SPRINGHURST BLVD",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "KRISTIN",
        "middle_name": "O.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "29695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64296957",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200087050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.