Individual provider Active NPI

Mohamed Issah Jalloh, MD

  • Rheumatology Physician
  • Louisville, KY
National Provider Identifier
1972008167
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
TP442 Issued in KY
Practice address
2800 Breckenridge LN Ste 410
Louisville, KY 40220-1780
Phone
(502) 928-0060
Fax
(502) 928-0069
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X TP442 KY Primary

Addresses

Primary practice location

2800 Breckenridge LN Ste 410
Louisville, KY 40220-1780

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 928-0060

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
I20240829001485 KY Practitioner - Rheumatology 4486193877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2800 Breckenridge LN
Suite 400
Louisville, KY 40220-1402
Phone (502) 895-1111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Baptist Medical Associates Inc CurrentSince Aug 1, 2024 Accepting new patients
Baptist Health Medical Group Inc PastSince Aug 25, 2024 Accepting new patients

Locations

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

2800 Breckenridge Ln
Ste 400
Louisville, KY 40220
Phone (502) 895-1111

2800 Breckenridge Ln
Ste 410
Louisville, KY 40220
Phone (502) 244-8702

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1972008167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-928-0060",
            "fax_number": "502-928-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BRECKENRIDGE LN STE 410",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201780",
            "telephone_number": "502-928-0060",
            "fax_number": "502-928-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOH",
        "first_name": "MOHAMED",
        "middle_name": "ISSAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "TP442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.