Active NPI
Larry Paul Griffin, M.D.
- Maternal & Fetal Medicine Physician
- Louisville, KY
National Provider Identifier
1972508133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- 17396
- Practice address
- 4130 Dutchmans LN
Ste 400
Louisville, KY 40207-4711 - Phone
- (502) 897-0697
- Fax
- (502) 897-0658
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | 17396 | KY | Primary |
| Maternal & Fetal Medicine Physician | 207VM0101X | MD21040 | DC | |
| Maternal & Fetal Medicine Physician | 207VM0101X | 01035329A | IN |
Addresses
Primary practice location
4130 Dutchmans LN
Ste 400
Louisville, KY 40207-4711
Mailing address
PO Box 950202
Louisville, KY 40295-0202
Phone (502) 588-9490
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2112000000044474 | Other | KY | BLUE CROSS/BLUE SHIELD |
| 50036611 | Other | KY | PASSPORT - WS |
| 2258716 | Other | KY | AETNA |
| 610673930S | Other | KY | HUMANA |
| 64173966 | Medicaid | KY | |
| 1097322 | Other | KY | PASSPORT |
| 0700557 | Other | KY | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160218002134 | KY | Order and Referring Only - Obstetrics/Gynecology | 5092725861 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD21040 | DC | MD | Maternal & Fetal Medicine Physician |
| 01035329A | IN | MD | Maternal & Fetal Medicine Physician |
| 17396 | KY | MD | Maternal & Fetal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1972508133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 950202",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402950202",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 DUTCHMANS LN",
"address_2": "STE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402074711",
"telephone_number": "502-897-0697",
"fax_number": "502-897-0658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "LARRY",
"middle_name": "PAUL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "KY",
"license": "17396",
"primary": true
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "DC",
"license": "MD21040",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "IN",
"license": "01035329A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "2112000000044474",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT - WS",
"identifier": "50036611",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2258716",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "610673930S",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64173966",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "1097322",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0700557",
"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 Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.