Louisville Gastroenerology Assoc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

LOUISVILLE GASTROENEROLOGY ASSOC

Practice address

1169 Eastern Pkwy
G58
Louisville, KY 40217

Phone

(502) 452-9567

Fax

(502) 473-0586

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Paul E Brown, MD

Title

Managing Member

Phone

(502) 452-9567

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952474785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "G58",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40217",
            "telephone_number": "502-452-9567",
            "fax_number": "502-473-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "G58",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40217",
            "telephone_number": "502-452-9567",
            "fax_number": "502-473-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE GASTROENEROLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "502-452-9567",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65933897",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.