Active NPI
Jacob Ryan Bishop, D.M.D.
- Dentist
- Louisville, KY
National Provider Identifier
1992158950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9778
- Practice address
- 13301 Shelbyville Rd Ste 105
Louisville, KY 40223-3937 - Phone
- (502) 631-9627
- NPI assigned
- Jul 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9778 | KY | Primary |
Addresses
Primary practice location
13301 Shelbyville Rd Ste 105
Louisville, KY 40223-3937
Mailing address
13301 Shelbyville Rd Ste 105
Louisville, KY 40223-3937
Phone (502) 599-8996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9778 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547769600000",
"number": "1992158950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13301 SHELBYVILLE RD STE 105",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402233937",
"telephone_number": "502-599-8996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13301 SHELBYVILLE RD STE 105",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402233937",
"telephone_number": "502-631-9627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "JACOB",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-14",
"last_updated": "2019-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "9778",
"primary": true
}
],
"identifiers": [],
"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 Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.