SUSAN RAGHAVAN, MD (NPI# 1386070019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386070019 |
| Entity Type | Organization |
| Organization Name | SUSAN RAGHAVAN, MD |
| Other Organization Name | CHILDRENS DIABETES AND ENDOCRINOLOGY |
| Practice Address |
9720 Park Plaza Ave Unit 202 Louisville KY 40241-2290 |
| Practice Telephone | 5023279703 |
| Practice Fax Number | 5023279798 |
| Mailing Telephone | 5023279703 |
| Mailing Fax Number | 5023279798 |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |
| Authorized Official Name | SUSIE MINSTERKETTER (BILLING DEPT) |
| Authorized Official Telephone | 5023279703 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
34555 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | PEDIATRIC ENDOCRINOLOGY | 2080P0205X | 01 |
| KY | 64880008 | 05 |
| Other Name | Type Code |
|---|---|
| Childrens Diabetes and Endocrinology | Doing Business As Name - Organization |
| Street Address |
9720 PARK PLAZA AVE UNIT 202 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241-2290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780737510 | Susan Raghavan | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1952876146 | Ashley Lynne Johnson Belcher | Psychologist | 9700 Park Plaza Avenue, Ste. 106, Louisville, KY 40241 | 2018-10-04 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1346767472 | Bridgett Lin Youngblood | Case Manager/Care Coordinator | 4313 Brownsboro Glen Rd, Louisville, KY 40241 | 2017-08-29 |
| 1518375690 | Amir Shahla | Dentist | 10500 Fischer Park Dr, Louisville, KY 40241 | 2014-08-01 |
| 1255741781 | Alicia M Durham | Marriage & Family Therapist | 3900 Riveroaks Ln, Louisville, KY 40241 | 2014-05-06 |
| 1962826719 | Applied Behavioral Consulting, LLC | Community/Behavioral Health | 4517 Shenandoah Drive, Louisville, KY 40241 | 2014-02-14 |
| 1336579176 | Nicholas Weickel | Physical Therapist | 9880 Angie's Way, Suite 100, Louisville, KY 40241 | 2013-11-14 |
| Find all providers in zip 40241 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780737510 | Susan Raghavan | Pediatrics | 9720 Park Plaza Ave Unit 202, Louisville, KY 40241-2290 | 2007-01-18 |
| 1659807881 | University of Louisville | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1835 | 2017-05-09 |
| 1093105306 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 601a, Louisville, KY 40202-3900 | 2015-01-26 |
| 1679985519 | Paul Hiers | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2014-05-27 |
| 1144586876 | University of Louisville Physicians, Inc. | Pediatrics | 210 E Gray St, Suite 803, Louisville, KY 40202-3900 | 2012-04-06 |
| 1447530910 | Priyanka Bakhtiani | Pediatrics | 601 S Floyd St, Ste 403, Louisville, KY 40202-1837 | 2011-08-27 |
| 1669765749 | Bradly Jackson Thrasher | Pediatrics | 411 E Chestnut St # St7, Louisville, KY 40202-1713 | 2011-05-23 |
| 1124159009 | Kupper Anthony Wintergerst | Pediatrics | 411 E Chestnut St # Street7, Louisville, KY 40202-1713 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811121692 | Evangelia Kalaitzoglou | Pediatrics | 2195 Harrodsburg Rd Ste 125, Lexington, KY 40504 | 2009-05-08 |
| 1023162492 | Wilburn Jackson Smith IIi | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2007-01-23 |
| 1326113234 | John Fowlkes | Pediatrics | 800 Rose St, Lexington, KY 40536-0001 | 2006-11-24 |
| 1346330909 | Alba E. Morales Pozzo | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1255421814 | Kathryn Thrailkill | Pediatrics | 740 S Limestone St, Lexington, KY 40536-0001 | 2006-10-13 |
| 1568482826 | Charles Charlton Mabry | Pediatrics | 740 S Limestone, Lexington, KY 40536-0001 | 2006-07-20 |
| City | LOUISVILLE |
| Zip Code | 40241 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.