NPIMap

Individual provider Active NPI

Tyler B. Holley, M.D.

  • Surgery Physician
  • Bardstown, KY
National Provider Identifier
1992184030
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
53693 Issued in KY
Practice address
4371 New Shepherdsville Rd
Bardstown, KY 40004-8040
Phone
(502) 350-5492
Fax
(502) 350-5822
NPI assigned
May 21, 2015
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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 NU
Surgery Physician 208600000X 53693 KY Primary

Addresses

Primary practice location

4371 New Shepherdsville Rd
Bardstown, KY 40004-8040

Mailing address

PO Box 936
London, KY 40743-0936

Other practice location 1

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515002456 KY Practitioner - General Surgery 2365873817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kentucky College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4371 New Shepherdsville Rd
Bardstown, KY 40004-8040
Phone (502) 350-1022

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy143
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux119
Melanoma (skin cancer) excision19
Removal of tissue21
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53693KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. Surgery CurrentSince Jul 1, 2020 Accepting new patients
Kentuckyone Health Medical Group, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Neurosurgical Associates PSC Current Accepting new patients

Locations

4359 New Shepherdsville Rd
Unit 245
Bardstown, KY 40004
Phone (502) 350-5492

4371 New Shepherdsville Rd
Bardstown, KY 40004
Phone (502) 348-5685

4371 New Shepherdsville Rd
Unit 100
Bardstown, KY 40004
Phone (502) 337-6815

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

Interoperability endpoints

  • Direct secure messaging: tholley275151@direct.stlukeshealth.org
  • Direct secure messaging: tylerholley@kysjhspe.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1992184030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NEW SHEPHERDSVILLE RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400048040",
            "telephone_number": "502-350-5492",
            "fax_number": "502-350-5822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-3562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "TYLER",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "53693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

Verify at the official NPI Registry.