Provider Demographics
NPI:1619138005
Name:SCHMIEDER, GREGORY C (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:C
Last Name:SCHMIEDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:3999 DUTCHMANS LN
Practice Address - Street 2:MEDICAL PLAZA 1, SUITE 1H
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4744
Practice Address - Country:US
Practice Address - Phone:502-636-7472
Practice Address - Fax:502-636-7130
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY42654208600000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY200959490OtherANTHEM INDIANA MEDICAID- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY3725700000OtherPASSPORT ADVANTAGE- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY00533138OtherMEDICARE KY- CARDIOTHORACIC SURGERY OF LOUISVILLE
IN200959490Medicaid
KY000023036XOtherHUMANA- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY7100074290OtherMEDICAID KY- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY105163OtherSIHO- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY50024781OtherPASSPORT- CARDIOTHORACIC SURGERY OF LOUISVILLE
KYP00733107OtherRAILROAD MEDICARE- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY000000620831OtherANTHEM- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY9295388OtherAETNA- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY50024781OtherPASSPORT- CARDIOTHORACIC SURGERY OF LOUISVILLE