MATTHEW GREGORY YANTIS (NPI# 1558621912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558621912 |
| Entity Type | Individual |
| Full Name | MATTHEW GREGORY YANTIS |
| Credential | M.D. |
| Practice Address |
4004 Dupont Cir Ste 220 Louisville KY 40207-4819 |
| Mailing Address |
4004 Dupont Circle #220 Louisville KY 40207-4761 |
| Practice Telephone | 5028930159 |
| Practice Fax Number | 5028930159 |
| Mailing Telephone | (502) 893-0159 |
| Mailing Fax Number | 5023123884 |
| Enumeration Date | 2012-05-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 01078700A | IN | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | 50401 | KY | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | BP10044563 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | LICENSE | 50401 | 01 |
| IN | LICENSE | 01078700A | 01 |
| IN | MEDICARE | 265400015 | 01 |
| KY | MEDICARE | K240890 | 01 |
| KY | 7100475900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 University Blvd, 7.104 John Sealy Annex, Galveston, TX 775550521 | 4097724688 | 4097721715 |
| Street Address |
4004 DUPONT CIR STE 220 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255503918 | Janet Martis Hedger | Audiologist | 4004 Dupont Cir Ste 220, Louisville, KY 40207-4819 | 2008-04-02 |
| 1336622281 | Michael D Beasley Jr. | Physician Assistant | 4004 Dupont Cir Ste 220, Louisville, KY 40207-4819 | 2018-09-06 |
| 1538512967 | Grace Isaacs | Physician Assistant | 4004 Dupont Cir Ste 220, Louisville, KY 40207-4819 | 2016-07-20 |
| 1629472956 | Lauren Hamilton | Physician Assistant | 4004 Dupont Cir Ste 220, Louisville, KY 40207-4819 | 2014-10-15 |
| 1023428695 | Casey Yeakel Hay | Otolaryngology | 4004 Dupont Cir Ste 220, Louisville, KY 40207 | 2014-05-05 |
| 1174811434 | Kristen Evans Hilsher | Audiologist | 4004 Dupont Cir Ste 220, Louisville, KY 40207-4819 | 2011-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720245657 | Sean Michael Maguire | Otolaryngology | 4600 Shelbyville Rd, Suite 220, Louisville, KY 40207-3326 | 2008-05-19 |
| 1548441850 | Dr. Harold Blevins | Otolaryngology | 5129 Dixie Hwy Ste 209, Louisville, KY 40216-1727 | 2007-11-15 |
| 1194929018 | Aesthetic Specialists Pllc | Otolaryngology | 10262 Shelbyville Rd, Louisville, KY 40223-2955 | 2007-06-13 |
| 1083731277 | Premier Ent and Allergy, Pllc | Otolaryngology | 2429 Bush Ridge Dr Ste 103, Louisville, KY 40245-5914 | 2007-03-23 |
| 1659420800 | Harold W. Blevins, M.d.,p.s.c. | Otolaryngology | 3999 Dutchmans Ln Ste 3a, Louisville, KY 40207-4747 | 2007-01-09 |
| 1912061599 | Jeffrey Brian Jorgensen | Otolaryngology | 401 E Chestnut St Unit 170, Louisville, KY 40202 | 2006-12-20 |
| 1821046426 | Harold W Blevins | Otolaryngology | 3999 Dutchmans Ln, Suite #3a, Suburban Plaza One, Louisville, KY 40207-4714 | 2006-05-05 |
| 1023006681 | Carl D Coppola | Otolaryngology | 2429 Bush Ridge Drive, Suite 103, Louisville, KY 40245-5914 | 2005-10-07 |
| 1730188285 | Jolene H Boswell | Otolaryngology | 4600 Shelbyville Rd Ste 220, Louisville, KY 40207-3398 | 2005-07-18 |
| 1467450049 | Andrew Simon Mickler | Otolaryngology | 3999 Dutchmans Ln, Suburban Medical Plaza I Ste 2g, Louisville, KY 40207-4729 | 2005-07-08 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.