Healthcare Provider Details

I. General information

NPI: 1548767668
Provider Name (Legal Business Name): SARAH GROUT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 E CHESTNUT ST
LOUISVILLE KY
40202-1821
US

IV. Provider business mailing address

304 E 91ST ST APT 1D
NEW YORK NY
10128-6582
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-6000
  • Fax:
Mailing address:
  • Phone: 860-961-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number56348
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number56348
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number336205-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: