Provider Demographics
NPI:1285715375
Name:NUSS, JAMES W (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:NUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4305 NEW SHEPHERDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9019
Mailing Address - Country:US
Mailing Address - Phone:502-350-5000
Mailing Address - Fax:502-350-5022
Practice Address - Street 1:4305 NEW SHEPHERDSVILLE RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9019
Practice Address - Country:US
Practice Address - Phone:502-350-5000
Practice Address - Fax:502-350-5022
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34992207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0000000542000OtherANTHEM
KY50017266OtherPASSPORT
KY3422341000OtherPASSPORT ADVANTAGE
KY64041338Medicaid
208M00000XOtherTAXONOMY
KY3422341000OtherPASSPORT ADVANTAGE
208M00000XOtherTAXONOMY