| Michael John Light, MD | |
|
1108 Main Street, Shelbyville, KY 40065 | |
| (502) 513-5058 | |
| (502) 513-5215 |
| Full Name | Michael John Light |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 30 Years |
| Location | 1108 Main Street, Shelbyville, Kentucky |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508863648 | NPI | - | NPPES |
| 64038847 | Medicaid | KY | |
| 2003610101A | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 01056762A (Indiana) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 36355 (Kentucky) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kentucky Psychiatry Llc | 6002184389 | 6 |
| Entity Name | Kentucky Psychiatry Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104358597 PECOS PAC ID: 6002184389 Enrollment ID: O20170608002297 |
| Entity Name | Ppl Therapeutic Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104323252 PECOS PAC ID: 8527323989 Enrollment ID: O20180606000408 |
| Entity Name | River Region Psychiatry Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386891497 PECOS PAC ID: 1254491012 Enrollment ID: O20241003003852 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael John Light, MD 1108 Main Street, Shelbyville, KY 40065 Ph: (502) 513-5058 | Michael John Light, MD 1108 Main Street, Shelbyville, KY 40065 Ph: (502) 513-5058 |
Lori Nation Legrand, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 213 Midland Blvd, Shelbyville, KY 40065 Phone: 502-410-0159 | |
Dr. Denise L Epperson, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 250 Alpine Dr, Shelbyville, KY 40065 Phone: 502-633-5683 |