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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SULLIVAN SCOTT SMITH DO
NPI 1235982455
General Practice in Louisville, KY

Active since April 08, 2024PECOS Enrolled
530 S JACKSON ST RM C1H17, LOUISVILLE, KY 40202(502) 852-5689 Get Directions Write a Review

NPPES record last updated: October 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 13, 2026, May 1, 2024, Apr 26, 2024 and 1 more (4 updates tracked since 2024).

About Sullivan Scott Smith Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SULLIVAN SCOTT SMITH DO (NPI 1235982455) is an individual general practice provider in Louisville, Kentucky, licensed in Kentucky (R7194) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235982455
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameSULLIVAN SCOTT SMITHCredential: DO
Location Address530 S JACKSON ST RM C1H17Louisville, KY 40202-1675
Mailing Address530 S Jackson St Rm C1h17Louisville, KY 40202-1675
Phone(502) 852-5689
Sole ProprietorNo
Enumeration DateApril 8, 2024
Last NPPES UpdateOctober 13, 20264 updates tracked since enumeration
NPPES CertifiedOctober 13, 2026
✔ NPI 1235982455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in KY · R7194
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
530 S JACKSON ST RM C1H17, Louisville, KY 40202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sullivan Scott Smith Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LANDEN PEHLE DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
LAUREN RAE GRECO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
SYDNEY GRONEMEYER
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
HANNAH HUDSON
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
SETH BENJAMIN BALLEW
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (256) 612-8636
ETHAN ZASTERA DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
JENNA CHADY
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689
AIMEE VERONICA CONCEPCION DO
Student in an Organized Health Care Education/Training Program
530 S JACKSON ST RM C1H17
LOUISVILLE, KY 40202
Jefferson County (502) 852-5689

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sullivan Smith's NPI number?

The NPI number for Sullivan Smith is 1235982455. It was assigned to this individual provider in the NPPES registry on April 8, 2024.

Where is Sullivan Smith located?

Sullivan Smith practices at 530 S Jackson St Rm C1h17, Louisville, KY 40202. The listed phone number is (502) 852-5689.

What is Sullivan Smith's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Sullivan Smith enrolled in Medicare?

Yes. Sullivan Smith is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sullivan Smith was last updated on October 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.